Category: News

“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 Fraud Causes Patient Suffering and Death

Posted on July 25, 2019 by - Medicare, Medicare Advantage, News

Medicare Fraud Causes Patient Suffering and Death

Medicare fraud is not a victimless crime. It doesn’t just affect the government; it affects you and your family in the form of higher taxes and reduced benefits as the government struggles to keep Medicare from going bankrupt.

 

But did you know that it has killed people? Did you know that it has also caused much suffering to patients? In the light of these 3 cases that I’ve found, the financial burden of fraud is not nearly as costly as the loss of life and human dignity.

 

Case #1: Unnecessary Narcotics Prescribed

According to the Atlantic, one case of Medicare fraud involved a Michigan doctor who “prescribed unnecessary narcotics in exchange for patients’ identification information, which was used to generate false billings.” This then caused the patients to become hopelessly addicted to the narcotics. It kept them coming back for more, which kept his scheme well funded until it was busted along with 242 other Medicare fraudsters on June 18, 2015.

 

Case #2: Fake Doctors Employed

In the AARP’s June 2016 Bulletin, they tell of Dr. Rafael Chikvashvili, a man who employed fake doctors to “examine the X-rays, ultrasounds and cardiac examinations that his company, Alpha Diagnostics, provided to nursing homes throughout the mid-Atlantic.” This gross malpractice cost 2 patients their lives to congestive heart failure. The fake doctors didn’t have the skills or knowledge to interpret these important tests. As a result, they ended up misinterpreting the patients’ X-rays or failing to diagnose the issue. Both of the patients didn’t get the care they needed, and they both ended up dying from their congestive heart failure. Chikvashvili faces life in prison for his actions.

 

Case #3: Chemotherapy Falsely Administered

In July of 2015, CNN released a report about Dr. Farid Fata, a hematologist who “gave cancer treatment drugs to patients who did not need them — including some who didn’t actually have cancer”. According to the article, these chemotherapy treatments were both painful and life altering. One of the victims lost all but one of his teeth due to the harsh treatments. In AARP’s June 2016 Bulletin, they claimed that he “improperly administered” chemotherapy to over 550 patients! Needless to say, he is now serving 45 years in prison.

 

Most fraud doesn’t affect the health and well being of patients, only finances. But every once in a while, a malicious case of Medicare fraud causes someone to lose her life or experience intense suffering like those victims who underwent years of unnecessary chemotherapy.

 

This is why we need to band together against Medicare fraud. The best thing you can do is to educate yourself. You need to be aware of what it is, whom it affects, and how to recognize it, so you can turn the fraudsters in. This saves the government (and yourself money), but beyond this, it could also save lives.

 

For more information about how to recognize Medicare fraud, click here:  How to Detect Medicare Fraud.

 

If you feel you have been a victim of Medicare fraud, please contact Medicare at 1-800-MEDICARE.

 

As always, if you have other questions, please call our office at 937-492-8800.

CONSUMER ALERT: Seniors Should Beware of DNA Testing Scam

Posted on July 3, 2019 by - Medicare, Medicare Advantage, Medicare Supplement, News, Retirement Planning, Social Security

COLUMBUS – Ahead of World Elder Abuse Awareness Day this Saturday, June 15, the Ohio Department of Insurance and the Ohio Department of Aging are warning Ohioans of a new scam targeting seniors. Ohio consumers should be cautious of genetic testing firms visiting senior communities or making unsolicited phone calls and mailings related to DNA screenings.

“Scam artists are always looking for new ways to steal money or personal information,” said Governor Mike DeWine. “We want people to be careful and to know the signs of a possible scam.”

 

In the scheme, which has been reported in Ohio and other states, firms reportedly collect consumers’ personal information under the pretense of DNA testing to screen them for cancer, Alzheimer’s, or other life-threatening diseases. Victims are told that Medicare will cover the cost of their testing. However, Medicare provides limited coverage for DNA testing (which is why consumers should consult their health care providers). As part of the scam, consumers often are asked for their Medicare card number and Social Security number.

 

“We want Ohioans to be aware and cautious as they consider DNA screening services,” said Ohio Department of Insurance Director Jillian Froment. “Consumers should never share their personal information, including Social Security number or Medicare card number, with anyone who reaches out unexpectedly. If you think you may be a victim of fraud or if you suspect potentially fraudulent activity, please contact us.”

 

“Scammers and shady businesses target older adults to steal money, get personal information, or in this case, improperly access individuals’ insurance benefits,” added Ohio Department of Aging Director Ursel McElroy. “As older adults get wiser to common scams, scammers are doing more to try to win their trust. Guard your Medicare or other insurance card like you would a credit card. To a scammer, it is just as valuable.”

 

To protect yourself, be alert if anyone conducting DNA cheek swabs requests that you agree to be billed for services in the event Medicare does not pay. These types of “testers” may be committing Medicare fraud because they are attempting to bill Medicare for a procedure that has not been ordered by a health care provider.

What Should Medicare Recipients Know About Genetic Testing?
  • In order for the testing to be covered by Medicare, it must be medically necessary.
  • Consumers should always confirm that their test has been ordered by their doctor, that it’s covered by their plan, and that it’s medically necessary.
  • If you are interested in DNA screening, talk to your doctor and determine if it is right for you.

How Can I Protect Myself from This Type of Scam?

  • If you or a loved one is approached by someone claiming to offer genetic testing, do not give your personal information (like your Medicare or Social Security information) to them.
  • Theft of Medicare card numbers may be used to commit identity theft or fraud.
  • Instead of receiving a DNA screening unsolicited from a firm not affiliated with your health care provider, talk to your doctor first and determine if the test is necessary.
  • Some consumers have reported receiving DNA testing kits in the mail without requesting them. Consumers should not use these kits but should instead talk to their doctor first.

If you suspect wrongdoing or if you believe you have been victimized, call the Ohio Department of Insurance’s Fraud and Enforcement Hotline at 800-686-1527 or the Ohio Senior Health Insurance Information Program at 800-686-1578.

Older Ohioans and their loved ones can learn more about scams and other forms of elder abuse and exploitation, along with ways to prevent and report them, on the Ohio Department of Aging’s website (www.aging.ohio.gov/elderabuse).

 

Source:  Ohio Department of Insurance

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

Posted on September 6, 2018 by - Medicare, News

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

Posted on September 3, 2018 by - Medicare, Medicare Advantage, News

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!

Warning: New Medicare Scams Coming!

Posted on March 2, 2018 by - Medicare, News

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.

Medicare Part B and D: Make More = Pay More

Posted on January 17, 2017 by - Medicare, Medicare Drug Plan, Medicare Supplement, News

Medicare Part B and D: Make More= Pay More

It’s true. The premiums for your Part B and D coverage for Medicare are adjusted for income.

 

I get it. It’s a little infuriating. You’ve spent all of these working years paying more in Social Security than everyone else, and now you find out they might come back for seconds.

 

But before any public pickets or private fist-shaking takes place, I want to grant you a little bit of comfort: according to Social Security, less than 5% of Medicare beneficiaries pay higher premiums due to income. And out of our clients, we’ve only come across a handful of affected people.

 

But to make sure, I recommend checking out the following chart. NOTE: There are separate numbers for filing individually, jointly, and filing individually when married, so make sure you are looking at the right one.

 

If your yearly income (modified adjusted gross income) in 2015 (for what you pay in 2017) was
File individual tax return File joint tax return File married & separate tax return You pay each month in 2017 for Part B  

You pay each month in 2017 for Part D

 
$85,000 or less $170,000 or less $85,000 or less $134  

Your plan premium

 
Above $85,000 up to $107,000 Above $170,000 up to $214,000 Not applicable $187.50  

$13.30 + your plan premium

 
Above $107,000 up to $160,000 Above $214,000 up to $320,000 Not applicable $267.90  

$34.20 + your plan premium

 
Above $160,000 up to $214,000 Above $320,000 up to $428,000 Above $85,000 and up to $129,000 $348.30  

$55.20 + your plan premium

 
Above $214,000 Above $428,000 Above $129,000 $428.60  

$76.20 + your plan premium

 

 

So there you have it. Did you make the cut? And now…

 

4 Things You Need To Know

  1. Premium increases are based on your MAGI

MAGI (Modified Adjusted Gross Income) is the magic number. It is calculated by taking your Adjusted Gross Income (all the income you’ve earned minus deductions) and adding some of those deductions back in such as IRA contributions. It is a little hairy, but for most people their Adjusted Gross Income is so similar to their MAGI, it is irrelevant.

 

  1. It is based on the tax return you filed last year

So, in 2017, whether or not you are cursed with higher premiums is determined by the tax return you filed in 2016 based on your 2015 income.

 

  1. Being married but filing separately can have costly effects

Pay close attention to those numbers. You’ll notice that the premium increases are much higher for comparable amounts of income. So file jointly unless you have a really good reason for doing otherwise.

 

  1. You can appeal to have the increase removed

This is a big one. The government has been known to make mistakes. So, if you notice that you were wrongly charged, you can fill out an appeal, and they will double check (I’ll keep my fingers crossed for you). This is especially helpful in the case of a “life changing” event that drops your income. The Medicare approved “life changing” events include but are not limited to:

  • Divorce
  • Marriage
  • Death of spouse
  • Work Stoppage
  • Loss of Pension

If you believe your IRMAA is incorrect, you can request that the Social Security Administration make a new decision.  You can contact them on the national helpline at 800-772-1213.

 

For those of higher income, it does seem like the government is doing a double dip. But I sincerely hope that you are not one of those affected individuals. Thankfully, the measure excludes most!

 

Confused about Medicare and not sure what to do next? Download our free E-book to get you started.   If you still have questions, call our office at 937-492-8800.

 

Photo:  www.affordablemedicareplan.com

Saying Goodbye to Supplement Plans F and C

Posted on January 11, 2017 by - Medicare, Medicare Supplement, News

Saying Goodbye to Supplement Plans F and C

(Why It’s Happening and Why It Matters To You)

You can pocket your tear-soaked hanky now. You don’t have to worry! If you are currently on plan C or F and have come to know and love it, the government will not force you to give it up. But for those of you yet to meet Medicare Supplement’s most comprehensive and popular plan (F) and his trusty companion (C), you may never get the chance. In 2020, the government will discontinue them both.

This begs the question: if the plans are so popular, then…

 

Why Are They Being Discontinued?

It’s a long story, but I’ll keep it brief. It all began with the “doc fix” bill, which President Obama signed into law back in 2015. The purpose of this legislation is to increase Medicare payments to doctors, so they continue to accept Medicare beneficiaries at their practices. Sounds like a good deal, right?

But by signing this bill, Medicare agreed to a hefty associated price tag of 200 billion dollars (according to The Hill). The money has to come from somewhere, so the federal government went to work on reforming Medicare in order to foot the bill for the bill (the bill’s bill, if you will). Phasing out plans C and F just happened to be the product of their brainstorm.

Here’s how they expect it will save Medicare money: Since plans C and F are the only ones that offer Part B deductible coverage ($166 in 2016), getting rid of both makes all Medicare beneficiaries responsible for their Part B deductible. Their hopes are that this will cause retirees to question their need to go to the doctor. The rationale is “if Medicare beneficiaries have a little more skin in the game (having to pay the deductible), maybe they won’t go to the doctor for every cough, ache, pain, or sniffle”. This—they believe—will save Medicare some cold, hard cash!

But this leads us to yet another “why” question…

 

Why Does It Matter to Me?

If you plan to enroll in Medicare after 2020, it’s quite obvious: plans C and F won’t be available to you. However, even if you are currently on plan C or F, saying goodbye to either one of these plans could have a costly effect on your monthly premium.

When a plan discontinues, it stops younger and healthier people from getting on the plan. This leaves an aging pool of beneficiaries, who (at least statistically speaking) have more health problems and file more costly claims. In order for the insurance provider to survive, they will likely counteract this loss with premium hikes.

Of course, this still leaves a lot of the 200 billion still unfunded, which—according to Forbes and Money Magazine—will likely come at high cost to Medicare beneficiaries.

To read more about how the “doc fix” bill could affect you, click the following link:

Proposed Medicare ‘Doc Fix’ Comes at a Cost to Seniors

 

Approaching 65 and not sure what to do? Click here to download our free E-book to get you started.  As always, you can call our office at 937-492-8800 with any questions.

 

Welcome!

Posted on July 8, 2010 by - News

Thank you for visiting Seniormark TV. We will begin posting educational videos in the coming days, we are just waiting on our video equipment. Thank you for being patient, it will be worth your wait.