Category: Medicare

Think Poor Health Will Stop You From Getting Medicare Supplement Insurance? Think Again.

Think Poor Health Will Stop You From Getting Medicare Supplement Insurance? Think Again.

Insurance companies can’t refuse you coverage for having cancer or being on an expensive chemo-treatment. They can’t deny you a policy for having diabetes or (Burger King-induced) sky-scraping cholesterol or any other pre-existing condition for that matter. These companies are federally mandated to grant you coverage as long as you enroll within the Medicare Supplement Open Enrollment Period. This is good news for you!

 

The Open Enrollment Period

The Medicare Supplement Open Enrollment Period is a 6-month window beginning the day you both turn 65 and are enrolled in Part B of Medicare. During this time frame, you have all the privileges of someone who doesn’t have poor health, including:

  • Access to all 11 Supplement plans (A, B, C, D, F, HDF, G, K, L, M, and N)
  • No premium hikes due to health conditions
  • No medical underwriting

 

You’ve Got Another Shot.

And then there’s guaranteed issue. Although this is based on very specific circumstances (such as coming off of employer insurance or your current plan discontinuing service), it still offers many people with pre-existing conditions another shot at getting on a plan. It is important to note, though, that some plans may not be available under guaranteed issue. It isn’t an all-access pass like the Open Enrollment Period, but it does give you the assurance to know you will not be denied.

 

 

It’s Not the End of the World!

But don’t sweat if you are no longer within the Open Enrollment Period. This definitely does not mean you won’t be able to get Medicare Supplement Insurance. It just means you will have to answer questions about your health, where they might look at your whopper addiction with a more critical eye.  You may have to pay more, but (depending on your specific conditions) they won’t automatically deny you coverage.

 

Of course, this doesn’t mean that there aren’t still circumstances where you will be unable to receive coverage. But—because of open enrollment and guaranteed issue—this doesn’t happen nearly as much. The government is making strides to ensure that health coverage is available to those who need it most: those who are unhealthy.

 

Need help picking out one of the 11 Medicare Supplement Plans? Want somewhere to start? Call Seniormark at 937-492-8800 or click here to set up a free consultation.

Why Dental Plans Aren’t Worth Their Weight in Premium For Retirees

Why Dental Plans Aren’t Worth Their Weight in Premium For Retirees

If you’re coming off your employer plan and onto Medicare, you might have been surprised to find out that neither Medicare nor Medicare Supplements cover most routine dental services. So I understand why you might find it quite attractive to get on a dental plan in addition to Medicare.   After all, who else will insure your million-dollar smile?

 

But allow me to reason with you. Because I believe that—in most cases—a dental plan just isn’t worth it.  Don’t believe me?  Using the pictured plan as an example, give me a few minutes to explain.

 

Scaling Benefits, Depleting Value

Way back when, Dental Plans had much better benefits. Their maximum benefits started on day one and continued until you dropped the plan.  But people abused it.  They got on a plan when they found out they needed a major surgery, let the insurance company foot the bill, and then cancelled the plan, getting away with no more than $30-40 in out-of-pocket costs.

 

The insurance companies needed to get smart if they were going to make any money.  So what did they do?  They fought fire with fire, and introduced scaling benefits.  Now most plans do not grant you full benefits until much later, after you paid your dues in premiums.  In the example below, the full benefits aren’t granted until 2 years.  In other words, not until you spend $800 in premiums!  The only thing the plan pays in full on day one is preventative services such as cleanings and exams.

 

Maximum Benefits

Here’s where a dental plan can really get you: the maximum benefits per calendar year is $1000.  This means you will never squeeze anymore than one grand out of them per year, no matter how long you’ve paid into the plan.

 

So what do you pay in premiums per year for this plan?  Let’s crunch the numbers.  $33.71/ month X 12 months per year = $404.52.  So, for all intents and purposes,  you pay about $400.  Consider this:  if you put the money you would’ve paid in premiums into a savings account, you would cover the maximum benefits in 2.5 years.  So—as long as you don’t expect to spend well over $1000 in 2.5 years—why would you bother with a dental plan?  For most people, it is just not reasonable.

 

You might’ve notice that you can upgrade your maximum benefits to $2000 dollars for an extra $7.61 in monthly premium.  But did you notice the fine print?  Without squinting, you probably didn’t.  So let me help you out with the gist: despite the upgrade, major services will still not exceed $1000.  In other words, for the services that actually have a chance of exceeding $1000 like dentures and oral surgery, the benefit limit is the same.

 

What to Do Instead

If you are still concerned about paying for routine checks, I would recommend telling the dentist you don’t have insurance and asking about “network pricing.”  A lot of times they are willing to cut the price (as much as 50% for exams and cleanings).

 

And if you are still concerned about major services that are going to cost up to $1000 or more, I recommend saving up what you would’ve paid in premium to put into a savings account.  In 2.5 years, you will have a thousand dollars of self-insurance for that million- dollar smile.

 

Need help with your retirement transition? Seniormark is here to help! Call us at 937-492-8800 for a free consultation.

Q&A: What You Need to Know about the New Medicare Cards and Numbers

Q&A: What You Need to Know about the New Medicare Cards and Numbers

I’m sure you’ve heard about it on the news or from a friend. If you haven’t, I would like to inform you now: As a part of the Social Security Number Removal Initiative, the Centers for Medicare and Medicaid Services (CMS) will be issuing new Medicare cards with a new number gracing the front. Unlike the old HICN number that is on all the old cards, this new number is not based on your Social Security number. Rather, it is a randomly generated 11-character identifier.

 

I anticipated a little bit of  “buzz” surrounding this topic, so I thought I would provide quick, simple answers to some of the questions you might be asking out of curiosity or general concern. Let’s get started.

 

How Much Will It Cost?

It won’t cost you anything. However, the government has set aside $320 million over five years to fund the initiative. It’s amazing how something as simple as changing numbers and letters on a card can end up costing so much!

 

Why Are They Doing It?

Think $320 million is a lot of money? How about $60 billion? As it turns out, that is one estimate of the amount of money Medicare loses every year due to fraud, according to AARP. The government hopes taking everyone’s Social Security numbers off the cards will help prevent identity theft and put a dent in that multi-billion dollar problem.

 

How Is My Medicare Beneficiary Identifier (MBI) Generated?

Unlike the old Health Insurance Claim Number (the number on your current card), which is based on your Social Security Number, your new Medicare number (the MBI) is a completely randomly generated 11-character identifier. It does not have any special meaning whatsoever.

 

For more information on the MBI, how it will look on the card, and each of the characters, see this helpful explanation.

 

When Will I Receive Mine?

They began the transition in April of 2018. Their goal is to have a new Medicare card in the hands of every active Medicare beneficiary by April of 2019.  You can also sign up at medicare.gov to receive an email when your state mails their new cards.

 

What Does This Mean for My Healthcare Provider?

Your doctors and care facilities will likely need to update their software and information systems to recognize the new number. Issues and challenges may arise as the transition takes place, but all the kinks should be worked out before you get your new card in the mail.

 

Do I Need to Do Anything?

Be sure to destroy your old card (it has your social security number on it), start using your new card as soon as you get it, keep the new number safe, and also check out our blog post about potential scams that may arise throughout this transition.

 

Do You Have Other Medicare Questions?

At Seniormark, we’re always here to help. If you have any questions about when and how to sign up for supplements, Medicare Advantage or drug plans, give us a call at 937-492-8800 or click here to sign up for a free consultation!

Watch Out for Medicare Scammers as New Medicare Cards are Issued

Watch Out for Medicare Scammers as New Medicare Cards are Issued

If you have read any of my other blog posts detailing the evils of Medicare fraud, then you know what a pervasive and serious problem it is. Not only does it cost Medicare recipients and taxpayers such as yourself millions in false claims, it can also cost lives in some rare cases due to malpractice and misdiagnosis.

 

This is why the Center for Medicare and Medicaid Services (CMS) launched an initiative to help tackle this complex problem. It is called the Social Security Number Removal Initiative (SSNRI), which accomplishes almost exactly what it sounds like it does. The measure ensures that Medicare will issue new Medicare cards to over 57 million enrollees with (you guessed it) the Social Security numbers removed. Instead the card will proudly display a new identification number called the Member Beneficiary Identifier (MBI). Medicare hopes that, with such an important number replaced on the card, it will make it more difficult for the bad guys to steal your precious identity.

 

However, the reason why I am alerting you of such a change is because the Better Business Bureau predicts that, scammers will prey on the uncertainty of this transition in the form of phone scams, and I do not want you to be a victim. Over the period of April 1, 2018 to December 31, 2019, be on special guard against these kinds of attacks. Knowing how this initiative will take place will help keep you safe. Therefore, keep the following things in mind about the SSNRI:

  1. You will not need to pay for your new card. If someone claims you have to, it’s a scam.
  2. You will not need to share your Social Security Number over the phone either. Reminder: Medicare will not call you or ask for personal information over the phone.
  3. You will not lose your Medicare Coverage in this transition. If anyone threatens this if you do not give them your information, it is a scam as well.
  4. This process is entirely automatic! Your new card will just show up in the mail sometime between April 1, 2018 and December 31, 2019.

 

It’s certainly frustrating that scammers can take an initiative designed to stop them and use the process as an opportunity to trick even more people. However, once you have your new Medicare card in hand, it will make it even more difficult on them. And, as long as you remember those four points, you will keep yourself safe in the transition as well.

 

Did you know that if you have been in the same Medicare Supplement for 4-5 years, you are likely overpaying for your coverage?  Click here to find out how much you could be paying:  https://seniormark.com/resources/#medicare-rate.

 

Want more information?  Contact our office at 937-492-8800 or via e-mail at admin@seniormark.com.  We are here to help!

New Medicare Cards Come with New Scams

New Medicare Cards Come with New Scams

 

There is great news for Medicare beneficiaries, and a bit of caution regarding scammers.  The good news is that Medicare will be sending out new Medicare cards to each recipient.  Mailing of the new cards will begin April 1st of this year and will be completed by April 1st of next year.

 

The new cards will not have the enrollee’s Social Security number on them, as they do now.  This is a major accomplishment for Medicare and is being done to help put a stop to identity theft via Social Security identification numbers.  This problem has been rampant nationally and is very serious business for Medicare enrollees who have had their cards compromised by internet bandits.

 

The new cards will have a randomly generated 11 digit number that even the holder will not be able to decipher.  So that is good news.  For the State of Ohio, delivery of new cards is scheduled to begin after June 1st.

 

But, along with the good news, bad news sometimes seems to follow.  The bad news is that Medicare scammers have already jumped into the game.  There is more than one technique involved, but these are the two most used.

 

First, scammers are calling Medicare recipients, sometimes identifying themselves as Medicare or “government” officials, and telling them that the new cards are coming out, but that they will have to send $30-50 to get the new cards.  This is bogus—there is no charge for the new cards—and CMS/Medicare does not call people—it only uses the US Postal Service to communicate.

 

The second technique is for the scammer to say that they have a Medicare Advantage Prescription Drug Plan available, but then request personal Medicare information so that the new plan can be utilized.  This is also bogus.  Whatever you do, do not fall for this.  Medicare information is personal, and the scammers simply use it for illegal activities.

 

So, we don’t know when or how the scammers will spring into operation in Ohio, or the Miami Valley region, but if you receive one of these calls, just hang up, and report the activity with a call to 1-800-Medicare.  And…above all, do not feel pressured to respond to any of these calls—the scammers are well-trained in intimidation and persistency.  Don’t fall for it.

Warning: New Medicare Scams Coming!

A New Wave of Medicare Scammers

 

Yet another wave of Medicare scammers is on the rise.  As new Medicare cards will be mailed out, seniors are finding themselves susceptible to phone scammers who are calling and identifying themselves as representatives from Medicare.

 

Callers are requesting payment for the new Medicare cards that are absolutely FREE.  Please be wary of such scams and not to give out private information about yourself.  Medicare will correspond only via mail.

 

To report a scam, please use the Better Business Scam Tracker or contact Medicare.gov directly at 1-800-MEDICARE.

 

In this latest attempt at medical identity theft, a caller posing as a Medicare representative will ask for payment in exchange for the new ID.  (The cards, which will be automatically sent sometime between April 2018 and April 2019, are free and require no extra steps.)

 

The same goes for someone asking if you want to purchase Medicare’s prescription drug coverage, known as Part D.  In this case a scammer may try to persuade you to buy Part D or lose your Medicare coverage.  (Part D is voluntary and has no impact on your health plan.)

Another common ruse is that you’re owed a refund from your insurance company and the caller needs your bank account number and Social Security number to deposit it.  A similar fraud also involves a caller claiming to be with Medicare requesting to update or confirm your information.  In each of these attempts at medical identity theft, scammers can then use your insurance to see a doctor, obtain prescriptions, buy medical equipment or even file a false claim.”

Scammers are taking advantage of the new security measures by targeting Medicare recipients before the changes roll out.  North Carolina Department of Insurance Commissioner Mike Causey says fraudsters are calling recipients, asking for personal information before the new cards come in.  He says they’ll ask you to verify your information, pay a fee or offer to track down your new card by using your old card information.”

If you have questions or concerns about the new Medicare cards, please contact our office for assistance:  937-492-8800.

Take Advantage of What Medicare Covers in FULL

Take Advantage of What Medicare Covers in FULL

Medicare alone doesn’t cover very much in full. There’s almost always some sort of coinsurance or copayment or other out-of-pocket cost.  This is why many people purchase Medicare Supplement Insurance to fill in the gaps (I recommend that you do so as well).

 

But there is something that Medicare fully covers—and that is preventive services. This includes lab tests, screenings, vaccinations, virtually any service performed to ensure that health problems are caught early—before they become…well…even bigger and more threatening problems.

 

This means that—as long as you meet basic eligibility requirements—you won’t pay a dime for most preventive services. The only ones I found that required any out-of-pocket costs were glaucoma screenings, diabetes self-management training, digital rectal exams (to detect prostate cancer), and barium enema (to detect colon cancer).

 

To give you an idea of the scope of preventive services that Medicare offers, here is a quick list:

  • Colonoscopies
  • Mammograms
  • Annual Wellness Visits
  • Diabetes Screenings
  • Vaccinations
  • Blood Tests
  • Depression Screenings

And this is just scratching the surface.

For a more comprehensive list with all the details, click here to access the Medicare preventive services guide.

 

Keep Track of Preventive Services on mymedicare.gov!

Some of these services are offered every year, some every other year, and some less or more often. Your risk level for certain diseases (based on age, gender, or family history) can also play a factor in how often you are eligible for services. Needless to say, it can be a lot to manage, which is why I recommend using mymedicare.gov. This free online account (among other things) allows you to see which preventive services you are eligible for and when.  Sign up here:  MyMedicare.  You can also print off a personalized report to bring to your doctor. This will help the both of you plan out when and if you should receive the various services.

 

I hope you consider taking advantage of what Medicare has made available. The reason they made it free is because they know how important it is for retirees to take care of themselves in a proactive way. It is good for them, and it is good for you—money wise and otherwise.  No one likes to spend time at a cold doctor’s office, especially when getting a colonoscopy (geesh). But staying on top of your health now, can save you having to deal with major health issues later. It can keep you on the go and healthy during retirement, an era of life that I believe should be as (if not more) fulfilling and exciting as all the rest.

 

Have any questions or concerns about Medicare? Call Seniormark at 937-492-8800 for a free consultation.

Turning 65 and not sure what to do?  Consider signing up for one of our FREE workshops in Sidney or Vandalia, Ohio!  Sign up here:  Seniormark workshops.

Can I Really Get a Medicare Advantage Plan For Free?

Can I Really Get a Medicare Advantage Plan For Free?

Yes, for quite a few Medicare Advantage plans, you will not have to pay a dime in premiums. And to sweeten to deal, you can even get extra benefits like gym memberships or a built in drug coverage with some plans. But I’m very stingy with my use of the word “free.”

 

From my experience, an Advantage Plan is free in the same way the newborn puppies of your best friend’s dog are “free.” You may not have to pay for the puppy, but how many know having man’s best friend around the house isn’t exactly a recipe for super savings (especially if you’ve got furniture and footwear that look especially appetizing in black and white)?

 

You see, a Medicare Advantage Plan might not cost anything in premiums, but it may eat up your money in the end. I’m not saying they aren’t right for some people, in fact; I’ve placed people in $0 Advantage Plans to their long-term satisfaction. For the cost-conscious retiree who is romping into retirement, healthy as a horse, it may be the best option. But before you purchase one, make sure you understand the hassles and extra costs that come along with the decision. I’ve outlined a few of the most important ones:

 

Networks

Advantage Plans have networks of health care providers that they have contracted with, usually within a fairly tight geographic area. If you do not receive care at one of their pre-picked providers, it can mean much higher copays and coinsurance amounts. If you are in an HMO plan, they may not even cover you at all while receiving care out of network. This can work just fine for a person who stays local most of the year, but it does put the burden on you to ensure that your health care provider is in-network. Making mistakes could cost you heavily.

 

Inconsistency

With a Medicare Supplement, the benefits are stable, but with an Advantage Plan, this is hardly ever the case.

 

Since the private insurance companies that offer Advantage Plans re-file their contract with Medicare every year, the benefits always change—sometimes dramatically. One of your preferred doctors could go out of network. Copayments, coinsurance, and deductibles can all shoot up. This is why you must review your plan every year so you won’t be caught unaware. If you set your plan to the side and forget about it (see “Don’t Set it and Forget It!) for even one year, it can be quite upsetting financially.

 

Potentially High Out-of-pocket Costs

I always like to remind people that Advantage Plans have more of a “pay as you go” approach. You pay less in premiums, yes.  But you may make up for it in deductibles, copayments, and coinsurance. For example, almost all Advantage Plans still keep you on the hook for the 20% coinsurance on Part B. That’s fine for an x-ray, but not as much for an outpatient surgery that may be $20,000 or more.

So be aware, Advantage plans do limit your annual out-of-pocket spending, but these caps are generally pretty high. If you have a period of extended illness, you could spend anywhere from $3500-6000 per year or more!

 

That doesn’t sound like free to me.

 

Need Expert Help Navigating Medicare? Confused About Your Options?

Click here to sign up for our free Medicare workshop or call our office at 937-492-8800 and get the guidance you need! No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

6 Annual Enrollment Dates You (Quite Literally) Can’t Afford to Forget

6 Annual Enrollment Dates You (Quite Literally) Can’t Afford to Forget

I know you’ve got a lot of dates to juggle: birthdays, anniversaries, holiday get togethers, or departure dates for long awaited travel plans. But you have to leave some empty space—in your memory and on your calendar—to add these 6 dates.

 

Why?

 

Because the Medicare Annual Enrollment Period is upon us, a time when the Medicare marketplace is bustling with transactions. Beneficiaries such as yourself are switching Drug Plans, Advantage Plans, or transitioning from an Advantage Plan to a Medicare Supplement or vice versa. These are strategic moves you can only make during Annual Enrollment!

 

Now, if you are thinking, “I’m perfectly fine with my health insurance. I’ll just let it go this year,” I’d like to offer a word of warning: Not reviewing your Medicare health insurance plans this Annual Enrollment Period could cost you thousands. You see, Benefits and premiums change from year to year, so you have to review your plans with a professional to ensure you are still in the best-valued plan for your needs.

 

It doesn’t seem like letting it slide just one year could end up being so costly, but I’ve seen it happen again and again. In fact, I recently had a man come into my office in January, confused about why his approximately $190 per month prescription wasn’t covered anymore. As it turns out, he missed Annual Enrollment. The insurance company dropped his prescription from their formulary (list of covered drugs) for the new year. Unfortunately, I had to tell him, he was stuck in the ill-fitting Drug Plan for the whole year, the consequences of a mistake that would (by the end of the year) cost him $2,280. Ouch.

 

So, if you are a current Medicare beneficiary, get your pen ready and calendar ready. Annual Enrollment (October 15—December 7) is chock full of clear-cut deadlines. Don’t find yourself locked into a financially draining health insurance plan! You (quite literally) can’t afford to miss these 6 dates:

1. October 1st

This is the day we, as an insurance agency, receive all of the new information regarding plan changes.

  • Did your Drug Plan drop your most expensive prescription from its formulary?
  • Was there a premium hike?
  • If you have an Advantage Plan, is your doctor still considered “in-network?”

October 1st is the day we have all these answers and can speak to you about the possibility of switching to save you money and hassle.

 

Note: You can call about your options anytime during Annual Enrollment, but the earlier is truly the better. This time of year is quite busy!

2.October 15

The marketplace is open!  Annual enrollment has officially begun, and you can now enroll in a new plan.

3.December 7

I hope you have made all the necessary changes, because—at this date—you are locked into your plans for another year. Annual enrollment is closed.

4.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.

5.January 1

Nope, you didn’t just read the same line twice, and you are not seeing double! I know this is a repeat, but I want to clarify why this date is worth the extra mention: It is also the first day of the Advantage Plan disenrollment period. Just in case you’re second-guessing your decision, Medicare set up a disenrollment period where you can get out of your Advantage Plan with no penalties.

6.February 14

Finally, 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.

 

Looking to Review Your Plans With a Medicare Expert?

Even if you are not yet sure if you want to switch, I recommend giving Seniormark a call at 937-492-8800! Our friendly and caring staff is more than willing to be a resource during this bustling Annual Enrollment season. We will help ensure you meet all the deadlines and end up in a great plan for your needs and pocketbook as the New Year rolls around.

Beat The Medicare Supplement Premium Creep by Shopping Around!

Beat The Medicare Supplement Premium Creep by Shopping Around!

If you’ve been in your Medicare Supplement Plan for 3-5 years or more without switching, it’s likely that you are overpaying big time.

 

You see, Medicare Supplement rates change from year to year. The one that was the best value last year may not be the best value now. In fact, they tend to creep—up and up and up.  And here’s why:

 

What Goes Up, Won’t Come Down

Medicare Supplement rates depend on total claim dollars the company pays out. Makes sense, right? The more money a company spends in claims, the more it needs to make, and the more it has to charge.

 

So as health care costs rise and policyholders make more expensive claims, premiums will slowly increase. And it doesn’t just stop. It continues to click upward, slow and steady, like a roller coaster.  Until—after a while—people unhitch their harnesses and exit in search of a more affordable plan.

 

But here’s the problem: the policyholders who leave aren’t the sick ones. Most of them wouldn’t be able to qualify for other insurance based on their health. No. The policyholders who leave are the healthy ones. The ones who balance out the budget, make fewer claims, and (ultimately) keep insurance companies in the black. This leaves an unhealthy pool of beneficiaries behind, the ones who need insurance the most and make the most (and the most expensive) claims.

 

So how does an insurance company cope? They let their premiums creep up even more, even faster. Click. Click. Click. But unlike a rollercoaster, the premium will never peak. It will never come back down.

 

Beat the Creep by Shopping Around!

But fortunately, most people don’t have to be stuck on that ever-climbing rollercoaster. Even if you have less-than-perfect health, you can shop around. As I said before—if you haven’t switched your Medicare Supplement Plan for 3-5 years or more, you’re probably paying too much! It’s time to switch.

 

Some More Good News

And this doesn’t mean you have to reduce your coverage either. You can get the exact same benefits for much less. Because of standardization, a plan F at one company is identical to a plan F at any other company. The same goes for all 11 Medicare Supplement Plans. So as long as the provider is decently rated (we usually recommend a B+ or above), you can go with the least expensive plan without sacrificing anything!

 

The bottom line is this: there’s really no reason to not take a look. We’ve had clients save hundreds a year by switching. So check the competition. Bargain hunt. Shop. You have nothing to lose, and a much lower premium to gain.

 

Need a quick way to compare Supplement prices? Use our Supplement Quoting tool to get you started. If you have any questions about what you find, call Seniormark at 937-492-8800. We’re here to help.

 

Resources