Category: Medicare Supplement

New Workshops Announcement

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

Visit our workshops page at www.seniormark.com/workshops to sign up for one or all of our workshops!

We look forward to seeing you there!

Attention Retirees: Premiums Shouldn’t Rule Your Healthcare Plan Decisions

Attention Retirees: Premiums Shouldn’t Rule Your Healthcare Plan Decisions

It is easy to do. If you’ve got a tight budget to think about, a drug plan with a low monthly premium is appealing. And if your past is fraught with health scares, it feels more secure to go with a high premium Medicare Supplement for “more comprehensive coverage”.

But you’ve got a lot more to consider when it comes to healthcare decisions: deductibles, coinsurance, copays, and medications, just to name a few. “Tunnel vision” focus on premiums will not help you make a smart decision.

 

Here are two examples why:

 

Lower Does Not Mean Better.

For a drug plan, people get in big trouble choosing a low premium drug plan hastily. Just because your friend or neighbor has an $18 per month drug plan that works for them, doesn’t mean it will work for you.

 

You have to consider your medications. Different drug plans cover medications at varying levels. If you are on an expensive drug and it isn’t on that plan’s formulary, it isn’t covered. If it is on a different tier, it could affect the dollar amount of copays you spend. Saving $10-15 a month on premiums isn’t worth it if you are paying an extra $150 a month on copays, coinsurance, or uncovered drugs. Pay the extra in premium for a drug plan that is right for you. Lower isn’t always better!

 

Higher isn’t always better, either.

I find that perceptions sometimes flip when it comes to Medicare Supplement Insurance. Clients believe that the most expensive and comprehensive plan is right for them, employing “you get what you pay for” logic. This saying is true a lot of times, but not always.

For instance, you can save approximately $20 per month by switching from a plan G to a plan N. The only difference between these two is a couple copays: $20 for office visits and $50 for emergency room visits.

This is where I lose people. They just don’t want the copays. But take a closer look. Is the free doctor and emergency room visits worth the extra $240 a year in premium? If you’re in good health, you probably only go to the doctor a few times a year for a general wellness test. It might save you $200 per year to go with a lesser coverage plan. In this case, it’s not worth it. When you compare the most comprehensive Plan F with G (see our blog “Underrated Plan G” by clicking here), you have another example, and that one is a no-brainer!

Of course, these choices are still up to you and your preferences. All I am asking you to do is not let premiums rule your decisions.

I’ve seen it work. Free thought leads to better value, all the time!

Need help shopping a Medicare Supplement Plan? Call Seniormark at 937-492-8800 for a free consultation!

 

Attention Retirees: Don’t Fall For These 2 Medicare Sales Tactics

Attention Retirees: Don’t Fall For These 2 Medicare Sales Tactics

Before the Medicare Improvements for Patients and Providers Act passed in July of 2008, Medicare Supplement salespeople had the upper hand. They could call you as much as they wished and show up at your doorstep uninvited. Medicare sales were practically a warzone.

Now, however, they have to be a little bit more clever about their sales tactics. Since they can’t contact you (except by mail) without your consent, they have to find some way to get permission from you—whether you realize what you are asking for or not. Here are two key strategies they use.

Online Quote Generators

It seems like an easy way to shop and compare Medicare Supplement prices in your area, but it may lead to a bombardment of unwanted calls and emails. Here’s how it works: When you put in your personal information like phone number or email, you consent to being contacted. You are essentially (but unknowingly) saying “hit me with your best shot!”

This is when the owner of these quote generators can sell your information to as many agents who care to buy. If you are one of the unlucky few whose contact is sold widely, you are in for an Armageddon of sales calls just like the barrage a client of ours so nobly braved. He claimed that within one minute of plugging in his phone number, the calls stormed in. To spare you the details, let’s just say he stopped picking up after 30 calls.

Tear and Return Reply Cards

I’ll bet your mailbox is practically bursting with Medicare literature. And I’ll bet a lot of them have a tear off reply card that asks for your contact information. Although it may seem official with its big “Do Not Destroy” stamps or fancy seals, this can be a ploy as well. If you can’t tell by the other content, there is a dead give away at the bottom of the mail in fine print where it says that an insurance representative may contact you.

 

“No. I’m not interested.”

I hope you don’t read this as “everything I get in the mail is bad” or “I should never give anyone my contact information” because this is simply not the case. There are wonderfully helpful people in the Medicare business who ask for your personal information. In fact, although we don’t ask for personal information, we send out mailers every month and have a quoting tool on our website!

The purpose of this post is to help you understand the difference between someone who trying to assist you and someone who is trying to badger you. No one wants his inbox overrun with spam. No one wants to answer a firing squad of phone calls a day with a sighing “I’m not interested.”

We know you don’t either.

If you would like to shop Medicare Supplements safely, click here to access our quoting tool. We don’t ask for any personal information!

Underrated Plan G Supplement Could Save You Hundreds a Year

Underrated Plan G Supplement Could Save You Hundreds a Year

Plan F is Medicare Supplement’s Cadillac plan. It is the one with the most comprehensive benefits of all 11 plans, reducing potential out-of-pocket spending for health insurance to an all-time low. It covers all Medicare approved expenses including deductibles, coinsurance, skilled nursing, and much more. Talk about a smooth ride! So when my clients are looking for a Medicare Supplement of high quality, that is usually the one they hop into. It is secure. It is hassle-free. And it’s just dang pretty.

 

But it is not always the best value. In fact, it rarely is, and here’s why:

 

Introducing Plan G

F G
Basic Benefits, including 100% Part B coinsurance Basic Benefits, including 100% Part B coinsurance
Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance
Part A Deductible Part A Deductible
Part B Deductible $183
Part B Excess (100%) Part B Excess (100%)
Foreign Travel Emergency Foreign Travel Emergency

 *Red means you pay

Take a thoughtful look at the Plan F and G benefits side by side. You’ll notice that these two plans cover most of the same things. From basic benefits to the hefty $1316 Part A deductible, it’s identical. The only difference is that Plan G does not cover the annual $183 Part B deductible.

                       

Cutting Costs

Yet the premium difference between these two plans is often staggering: sometimes $30- 50 or more a month. And if you take into account the amount saved in premiums, Plan F starts to lose its luster.

 

How about an example? Let’s say a 65-year old female from Sidney, Ohio is shopping for a supplement. For AARP’s Plan F, she would pay $151.90 per month. And for an Aetna Plan G, she would pay $113.95 a month. That is a $455.40 a year difference! Although she would be giving up the benefit of having her $183 deductible paid for, she would still save $272.40 a year by choosing Plan G!

 

It seems the best benefits don’t always mean the best value. The overall cost is what counts, 100% of the time. So when shopping luxury, keep this in mind: Always check to see what you are paying for. You just might find a better deal elsewhere.

 

Curious about how much a plan G would cost you? Use our Medicare Supplement quoting tool to find out! Click here to find out your best rates!  https://seniormark.com/resources/

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Do I Really Need a Medicare Supplement?

Do I Really Need a Medicare Supplement?

 

David Belk, a doctor and anti-supplement activist says, “…If you have Medicare and buy a supplemental policy with your own money, you are effectively giving an insurance company your money so that they can keep it.”

 

Wow. This statement is moving. For those who have had a Medicare Supplement Policy for years, it slaps you in the face with regret.

 

And for those who may not be on Medicare and have yet to purchase Medicare Supplement Insurance, it frees you. It justifies a decision that will save you money on premium month to month.

 

However, it is not entirely true. He has a point, but—ultimately—it represents a fundamental misunderstanding of what insurance is.

 

If you take this statement at face value, it would imply that virtually all insurance is worthless.

 

Here’s why: in the vast majority of cases, people pay into insurance and then rarely use it. This is what keeps insurance companies in the black.

 

How many people spend thousands over years on homeowner’s insurance and never have their house burn down? How many people purchase car insurance and only experience a couple of fender benders over their lifetime? Are they essentially “giving their money away to an insurance company”? Yes, you could say that, and it wouldn’t be inaccurate, just a bit misleading.

 

Because you don’t buy insurance for things you expect! Rather, you buy it for things with a high dollar amount of risk and a low probability of happening!

 

You can’t insure what is high risk and high probability. Take Alex Honnold, for example. He spends his waking hours climbing steep ravines with no safety harness. For hours a day, he is one missed footing away from plummeting to his doom. Do you think he is going to be able to get life insurance? It’s almost laughable. This is a high risk, high probability scenario. Of course no insurance company will take a chance on him!

 

You can insure against a low risk, low probability scenario, but why would you want to? Do you want pet insurance for your grandson’s gerbil? Obviously not. Even a low-premium insurance plan wouldn’t be worth it. What did you pay for it? 30 bucks? Maybe fifty if it’s some hypoallergenic, exotic breed? Either way, it’s not a high enough risk.

 

So this begs the question…what does a supplement cover? Is it something that is low probability and high risk?

 

Well…there are varying coverage levels, but even the lowest premium plans cover Medicare’s scariest coverage gap: the unlimited out-of-pocket spending limit.

 

Sure, a lot of them cover “nickel and dime” copays and coinsurance costs that virtually eliminate hassle and reduce costs, but this is just icing on the cake. The real substance of a Supplement Plan is that it puts a cap on your potential out-of-pocket spending.

With Medicare alone, there is absolutely no limit to what you can spend.

 

One of our clients had triple bypass surgery and ended up with a $7,000 bill. My father-in-law with lung cancer had approximately $30-40,000 in charges for outpatient chemotherapy and radiation. I ran into a man who—after a few years of extended illness—racked up over $140,000 in bills that Medicare alone didn’t cover.

 

Can you imagine the devastation if any of these retirees forfeited Medicare Supplement Insurance? If these individuals had chosen Medicare alone, those outrageous bills would’ve been heaped upon their shoulders.

 

Now, what are the chances of this happening to you?

Not very high.

But that is the point! What are the chances that your house is going to burn down? What are the chances that your car will get totaled? You can cite statistics like Dr. Belk and say, “Look…not very many people need this insurance.” However, this doesn’t make those isolated cases any less scary. And it doesn’t change the fact that, from 2006-2015, Medicare Supplement Insurance companies consistently paid out over 75% in claims what they gathered in premiums. Insurance is not about whether or not you are going to get out what you pay in; it is about peace of mind.

 

So yes…I do recommend buying Medicare Supplement Insurance. You don’t necessarily need an expensive, luxury plan, but having something in place is essential. Even if you can’t afford a Supplement, you can (at the very least), purchase a low or no cost Medicare Advantage Plan that will cap your annual out-of-pocket spending at $4-6,000.

 

This won’t guarantee that you won’t be “giving an insurance company your money” but it will guarantee that you can live your retirement life freely and fearlessly, knowing that—in all those unlikely but possible scenarios—

 

you’re still covered.

 

Wondering how much a Medicare Supplement will cost you? Click here to use our Medicare Supplement quoting tool to find out!

 

 

Know The Drug Plan Lingo! 5 Terms to Get You Started

Know The Drug Plan Lingo! 5 Terms to Get You Started

Every field or discipline has its own language. And to the undiscerning ear, it can all run together into nonsensical jargon. Mumbo jumbo. Gibberish. Flim flam. Drivel. You get the idea. But if you want to walk the walk and get ahead, you must first talk the talk. To get you started, you’ve probably come across these 6 terms in your Part D Drug Plan research.

 

Formulary

I’ll start with an easy one. The formulary is simply the list of drugs a particular plan covers. There are 24 drug plans at your disposal. Not all of them will cover the same medications. This is why it is important to check a plan’s formulary to find out if it’s right for you.

 

Prior Authorization

If a drug plan requires prior authorization, it means that they will not cover certain drugs unless your doctor or prescriber proves that the medication is medically necessary.

 

Step Therapy

Drug companies do not want you on an expensive drug when a less expensive one will be just as effective. For this reason, they will often make their beneficiaries start on a generic or cheaper drug as a trial to see if it works just as well. If it doesn’t, then the beneficiary can “step” up to the more expensive (often name brand) medication. This is called step therapy.

 

Quantity Limit

Quantity limit is exactly what it sounds like: a limit on the quantity of a specific drug that a plan will cover. Drug companies limit quantity to reduce waste, curb drug costs, and prevent unsafe use. For example, if someone is on a pain medication with a standard dosage of 2 per day, the quantity limit for a month will likely be 60 pills. They don’t want people getting addicted or wasting them through misuse or carelessness.

 

Tiers

Drug plan companies often organize the medications they cover into levels or “tiers”. Drugs on a lower tier (often generic brands) have lower associated costs such as copayments or coinsurance. Drugs on a higher tier (such as name brand or specialty drugs) often have higher costs.

 

The Donut Hole

The donut hole is a gap is prescription drug coverage. After you reach $3,310 in total drug costs, you enter the donut hole (resulting in higher out-of-pocket costs). After you reach 4,850 in out-pocket costs, you leave the donut hole and enter into what is known as “catastrophic” coverage where the plan will cover 95% of your drug costs.

 

All done! If you finished reading this, your Medicare literacy just increased. But if you have run into any more difficult terms, leave a comment. We are more than willing to answer your questions. Or visit Medicare Interactive’s glossary for additional Medicare vocabulary.

 

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

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 copays 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 copays 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!

 

Questions?

If you find yourself still searching for answers, one of our workshops might be for you!  Click here to sign up for one of our next workshops!

Looking to switch to or purchase a Medicare supplement, or Advantage plan? Call Seniormark at 937-492-8800 for a free consultation. We are here to help.

What Is the Fastest Way to Sign Up For Medicare?

What Is the Fastest Way to Sign Up For Medicare?

Once you’ve determined that it’s time to apply and have carefully considered all of your options, you are now ready to sign up for Medicare. You’ve got grandkids to get back to, family events to plan, and the world to explore, so you probably want to get this item off your to-do list as quickly as possible.

 

Fortunately, the federal government understands you in this respect. In response, they have designed a user-friendly website and an online enrollment process. It’s quick (taking only about 10 minutes). It’s easy (because you don’t have to leave the comfort of home). And the very fact that you are reading this blog proves you are tech-savvy enough to handle it.

 

To Apply Online, Just Follow These Few Simple Steps:

  1. Go to Social Security’s Website
  2. Click on the “Menu” Tab.
  3. In the “Benefits” section, choose “Medicare”.
  4. Scroll down and click the “Apply for Medicare Only” button.  (you will only be applying for medical coverage — not social security payments)
  5. In the “Apply and Complete” section, choose “Start a New Application”.
  6. The site will guide you from there.

 

Slow Down Partner!

But just wait! Before you start clicking away gung ho, I want you to consider how much thought you’ve put into your Medicare decisions. Not because I want to keep you from your grandkids, but because I know making mistakes in this process can result in unnecessary penalties and unexpected costs. If you haven’t sat down with a retirement expert in consultation, I strongly recommend doing so. It will take extra time, but—as the clichéd saying goes—sometimes slow and steady wins the race.

 

If you need someone to take this weight off your shoulders, give Seniormark a call at 937-492-8800. We make retirement decisions as quick and painless as possible!

 

Tax Penalty Alert: Mixing Medicare and HSAs

Tax Penalty Alert: Mixing Medicare and HSAs

Medicare and Health Savings Accounts just don’t mix.

Like oil and water. Like toothpaste and orange juice. Like shopping with grandkids and fixed budgets.

 

This is very important to know. When you start Medicare, either Part A or Part B, you have to stop contributions to your HSA account. Otherwise, you could be on the hook for some tax penalties. According to IRS publication 969, the penalty is 6% of your contribution and its interest until you remove the funds from your HSA.

 

So if you want to continue contributing to your HSA (legally, at least), you will have to delay getting on Medicare. But here’s the catch: Very few people can delay Medicare without receiving—you guessed it—penalties (there seems to be a lot of these nowadays). In fact, the only people who can forgo Medicare benefits without consequences are those who have adequate coverage with their employer through active employment. I’m not talking retiree insurance. I am talking Monday through Friday, on-the-floor or in-the-office work. It’s the only way.

 

And if you started receiving Social Security early and were signed up for Medicare automatically, I’m sorry to say you are stuck. You cannot contribute to your HSA, and it will be very difficult to get around it. This is because you are not allowed to opt out of Part A. Although you can drop Part B, being enrolled in Medicare Part A will still prevent you from contributing to your HSA.

 

However, it is important to note that you can still use the money in your HSA. There is no penalty for that. As a matter of fact, I would strongly encourage you to use your money. You’ve spent a lot of time building up that robust HSA; you might as well take advantage of it! You can use the funds for

  • Your Part B Premium
  • Your Drug Plan Premium
  • Your Advantage Plan Premium
  • Doctor’s Appointments
  • Copays

And this is just the beginning. There are many other qualified medical expenses you can use it for.

 

So don’t get too upset. You’re Health Savings Account is not obsolete. It’s just not going to grow much anymore. But that is just the way it is with a lot of things in retirement. Think of your nest egg. Your 401k. IRAs. It is just that time in your life when you stop working to save and start putting those hard-earned savings to work for you! When you look at it that way, it doesn’t seem too bad.

 

Have more questions about Medicare and your employer insurance?  Click here to receive your free copy of our handout:  The top 4 questions Medicare-aged employees ask about their employer health insurance.

 

If you still have questions — give our office a call at 937-492-8800.

 

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