Category: Medicare Workshop

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

Posted on September 23, 2021 by - Medicare, Medicare Advantage, Medicare Annual Enrollment, Medicare Supplement, Medicare Workshop, News

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

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

 

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

Benefits such as:

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

 

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

 

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

 

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

 

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

Medicare Supplement vs. Medicare Advantage: The Pros and Cons of Each

Posted on April 29, 2021 by - Medicare, Medicare Advantage, Medicare Supplement, Medicare Workshop, Retirement Planning

Medicare Supplement vs. Medicare Advantage: The Pros and Cons of Each

You may have encountered these buzzwords in television commercials, email blasts, or the piles of mail you’ve likely received from insurance agencies, but what do they mean? What is the difference between a Medicare Advantage Plan and a Medicare Supplement? Which is the best option for you?

 

First off, it is important to address that regardless of which option you choose, you need to sign up for original Medicare (Parts A and B) first.   As long as you’ve determined that you shouldn’t delay part B (because you plan to remain actively employed after 65), you should sign up for both within the 7-month period starting 3 months before your 65th birthday month.

 

Medicare Supplement, or “medigap” insurance as it is aptly nicknamed, fills in some of the gaps of what original Medicare does not cover.  However, Medicare is still the primary payer of your claims.

 

On the other hand, Medicare Advantage is an alternative; it replaces original Medicare as the primary payer of your claims and is offered through subsidized private insurance companies that have contracted with Medicare.

 

This difference makes a big difference when considering the benefits and detriments of each option—in dollar signs, security, and convenience. Because of this, let’s consider the pros and cons of each carefully.

 

Medicare Supplement (Pros)

Minimal Out-of-Pocket Spending – Although there are differences in coverage among each of Medicare’s lettered plans (A-N), supplements cover more gaps (such as deductibles, coinsurance, and copays) than Medicare Advantage.

Predictability – Not only is your coverage guaranteed to stay the same, the price is reasonably consistent from year to year. Although we recommend re-shopping your plan every 4-5 years to avoid the slow creep in premium prices, there won’t be any shocking or unprecedented changes.

Out-of- State Coverage – Supplements cover you in all states, not just your home state.

No Networks – You are able to use any doctor or hospital that accepts Medicare, not just ones within the preferred network of a specific insurance company.

 

Medicare Supplement (Cons)

Higher Premium – Medicare supplement premiums can range from around $70-270 with the average Medicare supplement premium in 2020 hanging around $134 a month for people aged 65-70. This is significantly higher than the average Medicare Advantage plan premium.

No Drug Plan – You have to buy a stand-alone Part D prescription drug plan, which has an average premium cost of 32.74 in 2020.

 

 

Medicare Advantage (Pros)

Low to No Premium– The Average Medicare Advantage plan cost in 2020 is about $36 per month in 2020 and a few are offered at no cost!

Built-in Prescription Drug Plan – Almost all Advantage plans include a drug plan, which means less hassle and no extra premium.

 

Medicare Advantage (Cons)

High Out-of-Pocket Spending  – Medicare Advantage may appear to cover more because they offer perks like vision, dental, and hearing (which are usually not worth covering ). They may even throw in a free gym membership. However, they usually cover less, employing more of a pay-as-you-go approach. For you, this means higher copays, coinsurance, and unexpected costs.

Unpredictability – Since the government subsidizes Advantage plans, your plan’s benefits and premium costs may vary widely from year to year.

Out-of-State Coverage…Sometimes – You can only receive coverage outside of your home state in emergencies.

Networks – Different Advantage plans have various preferred hospitals and doctors. If you do not use your plan’s preferred providers, you may find yourself with less coverage or—depending on the plan—no coverage at all.

 

The Bottom Line

All in all, the pros and cons of these two options can be summarized quickly and concisely: A Medicare supplement is more costly but with better benefits (leading to less hassle and more peace of mind); while a Medicare Advantage plan is inexpensive, but with fewer benefits (often leading to unexpected costs and stress).

 

But the bottom line is that both options do their jobs. They both limit the potentially high out-of-pocket spending that is left by Medicare alone. Whatever you choose, don’t leave yourself vulnerable to coverage gaps.  There are no pros to remaining with Medicare alone!

 

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!  Click here to sign up for our next workshop.

Will I Be Able to Afford Medicare?

Posted on June 11, 2020 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement, Medicare Workshop, Retirement Planning

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!

Aren’t All Medicare Supplements the Same?

Posted on November 17, 2017 by - Medicare Supplement, Medicare Workshop, Retirement Planning

Aren’t All Medicare Supplements the Same?

Yes.

Well…no.

Well— it’s at this point that I realize cut and dry answers don’t get along very well with Medicare. Or the federal government. Or really anything related to government for that matter.  And I am forced to give you the incredibly vague answer that sometimes isn’t an answer at all: yes and no. Allow me to expound.

 

Yes, they are all the same because…

 

Medicare Supplements Are Now Standardized.

Starting in 1992, the federal government came out with 11 plans labeled A through L, each with their own distinct coverage level and associated benefits. These 11 plans are identical no matter where you purchase them, which means that Plan F is still Plan F (offering the same coverage) whether you buy from AARP or Aetna or any other company.

 

However, just because the plans are standardized, that does NOT mean the prices are!

 

Which brings me to the inevitable…

No, they aren’t all the same because…

 

Prices Can Vary Dramatically—

As much as $100 a month.

And for the exact same benefits! Here’s an example. Let’s say you are a 65-year-old male from Sidney, Ohio who doesn’t use tobacco. If you purchased Plan F Supplement insurance from Banker’s Fidelity Life, it would cost $152.06 a month. However, if you purchased Plan F from Physicians Mutual Insurance, you would pay $294.33 a month. This is like having the option of identical minivans. Same make and model. Same gas mileage. Same features. Except one is almost twice as much. The choice is a no-brainer, right?  (Prices are current as of November, 2017).

 

 Now it’s time for something definite:

 

You should ALWAYS go to a trusted Independent Advisor (see my blog for reasons why here) for help.

 

They will get you into a plan that is right for you. Since they are independent, they are free to shop with a lot of companies to find the plan with the best benefits for the lowest cost.

 

Ahhh…the best value.

Now that is cut and dry.

 

Still have questions?  Sign up for our next workshop here:  workshop signup.

 

If you need help shopping for a Medicare Supplement plan, call us at 937-492-8800  for a free consultation!