Category: Social Security

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

Will I Be Able to Afford Medicare?

Posted on February 16, 2017 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement, Retirement Planning, Social Security

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. $134.00 will be your monthly premium unless you make $85,000 per year or more as an individual or $170,000 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 $15 to $128 monthly. The average cost for a drug plan is $35.63 in 2017. 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 $60 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 is only $166-366 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? 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!

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The Little Known Shortcut Out of an Advantage Plan You Hate

Posted on January 2, 2017 by - Medicare, Medicare Advantage, Social Security, Uncategorized

The Little Known Shortcut Out of an Advantage Plan You Hate

Buyer’s remorse. Everyone has been there. You might feel like you were misled, misinformed, or like you just plain missed it. But—regardless—it doesn’t feel good. And when you believe you’ve been locked into your purchase for a whole year—like people so often think after switching to an Advantage Plan—the regretful, trapped feeling only grows in intensity.

 

So you can imagine the relief when I tell my clients that there may still be a way out—a little known shortcut out of a seemingly costly dead end. This is exactly what I am telling you today.

 

It’s Called the Medicare Disenrollment Period

Extending from January 1st to February 14th every year, the Medicare Disenrollment Period offers you an outlet to drop the Advantage Plan you hate. All you have to do is call or write your Advantage Plan provider and notify them. From the time you drop your plan, the changes go into effect the 1st of the following month. No questions asked. You are then automatically signed up for traditional Medicare (Parts A and B).

 

Warning: Time Crunch Ahead

The vast majority of people will want to get on a Medicare Supplement before they dis-enroll from Medicare Advantage. If this is you, you want to plan ahead to ensure you have time to get it all done.

 

Although some people will have what is known as a “Guaranteed Issue Right” or a “trial right,” and therefore, won’t have to take the extra steps of getting approved, many people will not. In fact, most have a fairly cramped checklist to complete before February 14th arrives. They will have to

  1. Shop for a Medicare Supplement
  2. Apply for a plan (and undergo medical questioning)
  3. Receive letter of approval from the plan.
  4. Dis-enroll from their advantage plan.

All within the short 45-day disenrollment period! This is an especially difficult feat if the Medicare Supplement Company is running slow and the “receive letter of approval” portion of the to-do list takes 2 weeks or more.

 

So start early and finish the course way before Valentine’s Day. Because—although it may not say I love you—nothing kills romance like being stuck on a shoddy Advantage plan.

 

Any issues or concerns with your Advantage Plan? Contact Seniormark at 937-492-8800 for a free consultation.

 

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Aetna increasing household discount!

Posted on June 9, 2015 by - Medicare, Medicare Supplement, Retirement Planning, Social Security

seniormark favicon
logofinal black bagrMedicare Supplement Household Discount Increasing to 7% in OH

Aetna will increase the household discount from 5% to 7% on Medicare Supplement plans issued in Ohio effective June 15, 2015.

No action needed to get the higher discount

Eligible applicants and existing policyholders will receive the increased household discount.

  • For new business, the 7% household discount will apply to new applications written on or after June 15, 2015. All pending applications that qualify for the discount will be issued at the new 7% discounted rate.
  • For existing policies issued with an effective date of July 1, 2015 or later (with premiums already paid AND where eligibility for the household discount was provided on the application), AHLIC will issue a new policy, which will include the higher household discount.
  • All other policyholders who previously received the 5% household discount will automatically receive the 7% household discount on their future premium that have a premium due date of June 15, 2015 or later.

Excess premiums, if any, will be applied to the policyholder’s future premiums.

Is your Medicare Supplement currently with Aetna?  They are offering great rates in addition to this additional discount.  Call our office today (937-492-8800) to see if you might be able to save money with Aetna and Seniormark. 

Medicare Supplement policyholders are paying too much for their coverage!

Posted on July 21, 2014 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement, Retirement Planning, Social Security, State Teachers Retirement

If your parents were like mine, they probably taught you to spend your money wisely. Let me use a story here to make a point. Suppose you are shopping for a new refridgerator. Your first stop is at Sears where you find the perfect Frigidaire XL2014, and at a great price, $2100. But because your parents told you to shop before you buy, you decide to check a few more places. The last stop you make is at Lowes, where you find the same Frigidaire XL2014. Same make, same model, same features…they are IDENTICAL! Only the one at Lowes costs $1500. Do you go back to Sears and buy the one for $2100? Unless you own stock in Sears, or your son is the sales rep, I hope your response is…Absolutely not! Why would you spend $600 more on the same thing. But Retirees are doing that very thing with their Medicare Supplement insurance.

 

But you may ask, “How do I know I’m getting the same benefits?” The answer is simple, our government did something right. Prior to 1992, Medicare Supplement insurance plans were not standardized. What this meant was that each insurance company’s Medicare supplement plans offered different benefits. This made it almost impossible for the Retiree to shop their coverage from company to company. Compare it to shopping for a car today. You can’t really compare cost from one dealer to another because the options are completely different. This one has leather seats, but the other one has On-Star. This one has a DVD player, but the other one has alloy wheels. It is impossible to truly compare cost because you are never comparing “apples to apples.” The same was true with Medicare Supplement insurance prior to 1992. But in 1992 the federal government stepped in and “standardized” Medicare Supplement insurance.

 

They did this because prior to 1992, unethical salespeople were taking coverage away from Retirees in order to save them money, and they weren’t disclosing the fact that they reduced their coverage. So the government stepped in and standardized the plans so this couldn’t happen anymore. They did this by offering 11 plans and giving them the letter names of A through N. In other words, it means you can compare a Plan F with one company to a Plan F with another company and know that the benefits are IDENTICAL. So you no longer have to say, “I know my supplement is expensive, but I don’t want to change it because it pays so well.” As long as you stick with the same Plan letter name, the new company is legally obligated to pay the same benefits as your old one.

 

So what does this mean for you? It means it would be a good idea to know what premium you pay compared to what others your age and in your area are paying for the same plan. This is important because you may be paying hundreds if not thousands of dollars more per year in premium and not be getting any better benefits. For example, the premiums for a Plan F for a 70 year old female range from $130/month on the low end up to $276/month on the high end. That’s a difference of $1,752 per year. And worse yet, the person paying $276/month is not getting any better benefits than the person paying $130. And don’t forget, you can change your medicare supplement policy any time of the year…you don’t have to wait for the Annual Enrollment Period at the end of the year.

 

If you would like to see how your premium compares, you can go to our website at www.seniormark.com and click on the “Supplement Rates” tab. And don’t worry, you will get instant numbers and we won’t collect your personal information. If you are not tech savvy just call us at 877-492-8803 and we will provide you with a free comparison report.

 

I bet your momma never thought shopping would be this easy!

Seniormark Alert: Observational Status could cost you tens of thousands of dollars

Posted on January 23, 2014 by - Medicare, Medicare Advantage, Medicare Supplement, Social Security

For the past year and a half I have been talking with clients about the difference between an “Inpatient” hospital stay vs. being in the hospital under “Observational Status” and why it matters.  If you missed my previous blog post on this issue you can read it HERE.

This information is finally getting media coverage which is good because what you don’t know can Hurt A Lot!  Here is NBC Nightly News’ coverage of the topic from a few weeks ago:

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Feel free to comment below if you have any questions…

Can Medicare Advantage survive PPACA?

Posted on September 6, 2013 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement, Retirement Planning, Social Security, Uncategorized

Here is a great article about how the Patient Protection and Affordable Care Act (aka Obamacare) may affect the Medicare Advantage program…

Can Medicare Advantage survive PPACA? | BenefitsPro.

Donut Holes Aren’t Always Tasty!

Posted on February 2, 2012 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement, Social Security

If your brain works like mine, it thinks about food a lot more than it should.  And it’s always food that’s not good for me, like donut holes.  Nothing beats a donut hole.  It’s like eating a whole donut in one bite…AWESOME!

But when it comes to the Medicare Prescription Drug Plan, donut holes lose their luster.  Don’t ask me why Medicare decided to give it the name donut hole, maybe it was to take the edge off its bite (no pun intended, unless you think it’s funny).  The Donut Hole, otherwise known as the coverage gap, is exactly what it sounds like.  It is a hole in your coverage.  Here’s how it works according to the Medicare guidelines:

Stage 1: The plans start off with a “Deductible Period.”  This is the amount you must pay for out of your pocket before the plan will pay anything.  Not all plans have a deductible.  The plans cannot have a deductible higher than $320.

Stage 2: After you have met your deductible (if you have one) you go into what is called the “Initial Coverage Level.”  During this stage you will pay approximately 25% of the cost of the medication.  Most drug plans set up copays during this stage based on the medication which they assign to a Tier.  For instance, you might pay a copay of $5 for generics (Tier 1), $25 for formulary brand names (Tier 2) and $45 for nonformulary brand names (Tier 3).

Stage 3:  Once you have had $2930 in total drug costs, you will go into the “Donut Hole.”  Notice I said “total drug costs.”  This means what you paid for the medications plus what the plan paid.  For example, if the total cost of a medication is $100 and you only had to pay a copay of $25, it’s the entire $100 that goes toward the donut hole number.  Once in the donut hole you will pay 50% of the full cost of any brand name medications and 86% of the full cost of any generics.  Due to the new healthcare reform, these percentages will continue to decrease each year until they reach 25% in the year 2020.

Stage 4:  Once you have paid a total of $4700 in out-of-pocket costs (not including the premium for the plan), you enter the “Catastrophic Coverage Level.”  Notice that this amount is out-of-pocket meaning that you would have to pay a total of $4700 before you entered this next level.  Once you hit this level you would only pay approximately 5% of the cost of the medication for the rest of the calendar year.

Once you reach the end of the calendar year, all plans start back at Stage 1 on January 1st.

According to a report from the Kaiser Family Foundation, approximately 19% of Medicare beneficiaries reach the donut hole at some point during the year.  So not everyone has to worry about hitting the donut hole, but if you do your expenses can add up in a hurry.  For those of you who are in this situation, maybe you can ease the pain with a box of donut holes (the good kind from the local bakery).

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Bullies Ain’t Just in Elementary School

Posted on January 27, 2012 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement, Social Security, Uncategorized

Everyone remembers the bully from their elementary and high school days.  In most cases it was the stronger picking on the weaker.  You would think that 30, 40, or 50 years later things would be different, but it seems nothing has changed.  Not a month goes by that I don’t hear a story from one of my clients about an insurance agent bullying them or someone they know.  Bullying in the insurance industry comes in many different sizes and colors.  A few of them come to mind based on recent events…

1.  They prey on your fears!  I just received a call today from a new client of ours who we saved money by switching her from her existing medicare supplement policy to a policy with one of the companies we represent.  She had called very upset because she had just received a phone call from her previous agent.  He had called to tell her about all the coverages she would be losing by switching to the new supplement company.  He had proceeded to tell her that she would no longer be covered for preventative services (not true), that she would be responsible for a $155 deductible (this was the deductible amount for 2010, he was off a couple of years) and that one of her routine tests would no longer be covered (also not true).  If this agent was sincerely looking out for his client, then I apologize.  But at the least, he should know the plans he is representing.  If he was only concerned with the loss of his commission, then SHAME ON HIM!

2.  They prey on your good will!  No one “likes” to tell someone NO, or hurt someone’s feelings.  Pushy agents know this, that’s why they continue to push.  If they push long and hard enough they know that you will give in and buy, you don’t want to hurt their feelings, right.  You would recognize these agents if you ever told them NO, because many times they will get angry and rude when they don’t get the sale.  I recently met with a woman who was TOLD by an agent that the agents plan was much better than what she had and the agent proceeded to fill out an application without asking the woman if she wanted to move forward.  Not really knowing if the plan was better or not, and not wanting the uncomfortable feeling of saying NO, she proceeded to sign the paperwork and complete the sale.  She had told me afterward that she felt very uncomfortable with the agent.

3.  They just plain bully you!  Another recent experience I was told was from a woman we had switched from her current policy to a new policy with us.  She ended up cancelling the new policy because her existing agent had called her and TOLD her that she couldn’t switch because HE was her agent and HE was the one she had to work with.  Worse yet he told her that he was on vacation and that he would deal with it when he got back.

Now don’t get me wrong, there are a lot of agents out there who really do care about you and are doing their best to help.  I also know that the above examples are just one side of the story, so if I was getting the wrong side I apologize.  But I hear stories like this more frequently than I should, which tells me that many of them are, unfortunately, probably true.  When did money become more important than people?  To the agents who are bullying, KNOCK IT OFF!  To those of you who are being bullied, STAND UP AND SAY NO!