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 up 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 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?

Call our office to schedule a free one-on-one appointment to have an in-depth discussion about the ins and outs of Medicare.  During this time, we offer phone appointments, Zoom appointments, and in-person appointments to fit your level of comfort.  Call us today at 937-492-8800.

Dental, Vision, and Hearing: 3 Medicare Coverage Gaps You Probably Shouldn’t Insure

Many soon-to-be retirees find themselves concerned about transitioning from their employer insurance to Medicare because of the numerous coverage gaps, and I truly get it. If you spend a good deal of your career in an all-inclusive employer plan, switching to Medicare will feel like going from a gourmet buffet of benefits to a fast food value meal.

Prompted by that feeling, people often question: should I fill the gaps with extra insurance?

Now, this is a tricky one. For some of these gaps, I can definitely recommend it:

• 20% coinsurance on outpatient care.
• Minimal coverage on extended hospital stays.
• Limited coverage on skilled nursing care.

These are all viable reasons to seek extra coverage (usually in the form of a Medicare Supplement). And in the face of the fact that Medicare provides no out-of-pocket spending limit, I always recommend that every retiree have something to cap that off—whether it is a more expensive Supplement or a low to no cost Advantage Plan.

But then there are the strong three my clients consistently bring up: dental, vision, and hearing. As you may have heard, Medicare covers very little of these three. In fact, other than some complex dental surgeries received in a hospital and cataract removal, coverage for these three areas is basically non-existent.

But I have trouble recommending they get any insurance to cover them. I’m not saying there aren’t a few cases here and there (i.e. people who consistently need twice as much dental work as car repairs), but quite frankly it is just not worth it for the vast majority of retirees.

And here’s why…

Dental

You are likely going to spend about $400 per year for a stand-alone dental plan, which doesn’t sound like a lot until you hear what that money is really paying for. If it covered the entire cost of multi-thousand dollar oral surgery, then it might be worth it. But that’s exactly the problem: it doesn’t.

In fact, the maximum annual benefits for a dental plan is only $1000 in most cases. This is fine for the small stuff, the crowns or fillings that you could likely pay for on your own from a separate savings accounts. However, for the big-ticket items (the things you actually need insurance for), it doesn’t lighten the load all that much.

Vision

As far as vision goes, this is hardly ever bought as a stand alone, but is typically added on to the dental plan. And, like a dental plan, the benefits are equally lackluster.

Hearing

When retirees think of coverage for hearing, they are usually considering a big hearing aid expense with the testing and diagnoses and equipment. There is one Advantage Plan that offers up to $3,000 of coverage for hearing aids, but then you have to consider that you may be giving up your rights to purchase a Medicare Supplement in the future, which often provides more comprehensive coverage on all fronts.

Are you willing to give up full coverage for outpatient services (only provided through a Medicare Supplement) for help on a one-time hearing aid expense?

Not very many are.

The Bottom Line

In all of this, we must remember one thing: insurance is for those things in life that provide a huge risk. It is for those things that would cripple us financially. You can buy insurance for your appliances, your gerbil, your front door, and your potted plants, but that doesn’t mean it’s a good idea.

And when it comes to dental, vision, and hearing, (although I don’t think it is as ridiculous as potted plant insurance), it isn’t a high enough risk.

Believe me. If there were a magical plan that bundled hearing, vision, and dental into a $30-40 per month plan and then covered all of your needs in these areas 100%, then I would be the first to recommend it to my clients. But the truth is, insurance companies need to make money, and—therefore—these kinds of plans don’t exist. Insurance companies (at least the ones who don’t go bankrupt) will always win at the numbers game.

What I usually recommend to my clients (if they are still concerned) is a little bit of self-insurance. Take the money you would’ve paid for extra insurance and put it in an emergency savings account. In 2.5 years, you’ll already cover the maximum annual benefit of a dental plan.

And after a few more, you’ll have enough of a cushion to be sitting pretty, virtually unconcerned about your hearing, vision, and dental care needs.

Looking For a Helping Hand as You Transition to Medicare?

At Seniormark, we are here to guide you through the process, answering any and all of your questions along the way. We will help you find an insurance plan that fits your unique needs and pocketbook. Call us at 937-492-8800 for a free consultation!

5 Christmas Traditions You Can Start With Your Grandkids

It’s that time of year again. Sleigh bells are ringing. The neighbors are putting up an epic lights display or (for the less ambitious) a wreath and floodlight. And in elementary schools everywhere, little kids are counting down the days until Christmas break.

If they don’t spend all of their free time romping in the snow, this means more visits from the grandkids and more opportunities to start traditions and make priceless holiday memories.

From all of us at Seniormark, here are a few ideas to liven up those visits with spirited traditions to help others and have fun!

Bake Some Christmas Cookies—And Put the Grandkids on Decoration Duty

Blast a Christmas music playlist (perhaps one that the grandkids help create) and spend a wintry day inside the warm house baking. Then, when the cookies are all good and cooled off, ice them, and then break out the holiday sprinkles of all shapes, sizes, and colors for a decorating party. With the extra help, you can make enough for them to take home for their parents, themselves, and Santa.

My mom does this every year with the grandkids, and they love it. And, considering the fact that her famous sugar cookies rarely make it to New Years, I think it is safe to say the adults like it as well.

Go Out and Look at Christmas Lights—and Make a Scavenger Hunt Out of it!

Make some hot cocoa, hop in the car, and enjoy the light show one evening with your grandkids. The lights are beautiful to see on almost every house, but there are always those choice few houses that really make it spectacular (A.K.A. the try hards J).

You can even make it into a scavenger hunt with a checklist like this one. The first one to find a blow up peanuts character wins!

Put Together an Operation Christmas Child Shoebox

This is a great way to get your grandkids thinking about others this holiday season. Instead of always thinking about what their own gifts will be, it gives them an opportunity to think about what it might be like for other children who are not quite as fortunate as them.

With this organization, each of your grandkids can fill a shoebox for a child that is their same age. So take a few hours and head up to Walmart to do this with them. It will mean a lot to them, and it will bless a child in need. What a wonderful tradition!

Make a Special Ornament With Them

Every kid likes crafts, and ornaments that have memories behind them are much better than generic ones, so why not spend a few hours with your grandkids and make it happen. This buzzfeed article has a lot of great ideas for different ornaments you can make from clothespin reindeer to bottle cap snowmen.

You’ve Heard of Elf on the Shelf, But How About Kindness Elves?

The elf that gets into mischief has become very popular in recent years, but these elves suggest random acts of kindness as they move around the house during the night. Then, after the child completes his act of kindness, the next day the elves give the child a postcard to put in their “Little Book of Big Kindnesses.” This will work best if your grandkid lives close and comes over often during the Christmas season!

Just poking around the Internet, there are tons of other ideas out there. This post from theimaginationtree.com is my favorite collection of ideas. But whether you take one of our ideas, take up one from theimaginationtree.com, or invent your own, be sure to savor every moment of Christmas joy with your grandkids.

All of us at Seniormark wish you a Merry Christmas and blessed New Year!

Confused about Medicare and your options? Call Seniormark at 937-492-8800 for expert help at no cost to you!

Learn the 4 Parts of Medicare in Under 4 Minutes

Understanding your healthcare options as you approach 65 is necessary, but let’s face it: Medicare is confusing. You’ve got enough sales mail from local agents to keep a campfire going indefinitely, but none of it seems to make anything any clearer. You’ve likely tried to do some research only to find that Medicare has more letters than your high school algebra class.

That is why I am going to explain four of those letters today: Medicare Parts A, B, C, and D.  My goal is that you get to the end with some of the Medicare fog lifted.

Part A (Inpatient Care)

Part A is hospital insurance. In other words, it is coverage for care received while officially admitted to a hospital. Beyond that simple definition, Part A also covers skilled nursing facility care, hospice, and home health care. Luckily, Part A is free as long as you’ve paid into Social Security for at least 10 years. Except for extremely specific circumstances, everyone should sign up for Part A when they turn 65.

Part B (Outpatient Care, A.K.A Medical Insurance)

Part B is exactly the opposite, covering care received while checked out of a hospital. This includes diagnostic tests, x-rays, outpatient surgeries, and lab tests. It also covers a host of preventive services in full to help you maintain good health as well as catch any major health problems while they are easier to treat and manage. Part B costs $144.60 a month in 2020. Most people should sign up when they turn 65, but if you plan on continuing working, it might be cost-effective to delay Part B.

Part C (Medicare Advantage)

This is where things get a little messy. Although Part C is a Medicare associated program, it actually replaces Medicare as the primary payer of your claims. As opposed to being offered by Medicare, it is offered by private insurance companies who have contracted with Medicare. Medicare Advantage Plans cover everything that Parts A and B cover; in fact, they usually throw in extra benefits such as an out-of-pocket spending limit and prescription drug coverage. However, you can’t purchase a Medicare Supplement with an Advantage Plan, which is often used to fill in the more costly coverage gaps Medicare leaves wide open. You must be enrolled in Parts A and B before you can enroll in Part C.

Part D (Prescription Drug Plan)

If you choose to get an Advantage Plan, prescription drug coverage is likely included. But for everyone else, you must purchase prescription drug coverage under Part D of Medicare. The cost of Part D is difficult to estimate because it varies based on the company you choose and the medications you take. But—to give you an idea—the average price is around $32.74 per month in 2020.

Well, there you have it! Check the timer. Has it been less than four minutes? And—more importantly—check your understanding. Do you feel a little less foggy about the four parts of Medicare?

Still Have Questions?

If you answered yes to both questions, we did our job. And if you still have questions (as I’m sure you do), sign up for our free Medicare workshop! Our workshops are not a long-winded sales pitch. Instead, we seek to educate you about your options so you can make the best choices and avoid costly mistakes and penalties.  To sign up, call our office at 937-492-8800 or sign up online here:  workshop signup.

Annual Enrollment Period (AEP) To-Do List

1. Write the important Annual Enrollment dates to remember on your Calendar, and clip your calendar on your fridge.
2. Don’t eat that midnight snack until you’ve read the dates at least once.
   1. October 1^st— we can talk about your options!
   2. October 15^th— The AEP games begins.
   3. December 7^th—AEP comes to exhausting close.
   4. January 1^st— Plan changes go into effect. Double Whammy: You can also drop your advantage plan starting the 1^st all the way through the 14^th (which is also Valentine’s day…you’re welcome)
3. Compare your medications to the formulary (drug list) mailed to you by your drug plan company.
4. Consider changing your drug plan if some of your medications are no longer covered or if the premium is too high.
5. Call OSHIIP with any drug plan questions.
6. Call us and set up an appointment to have a good chat about your Advantage Plan.
7. Consider switching Advantage Plans if:
   1. Your hospital or doctor went out-of-network
   2. Plan changes for the following year result in jaw-dropping out-of-pocket spending or a high premium.
   3. Your Advantage plan is (all around) a bit of a drag.
8. As a golden rule, your ultimate to-do list item is …plan ahead!

Want help looking at your Medicare policies?  Call our office and we will guide you through the process.  937-492-8800

Attention Retirees: Stay on Top of Your Health Insurance With This Helpful Online Tool

Life is complicated and hard to manage. And what younger people don’t realize is that it doesn’t just all stop once you retire. As long as you’ve got goals and dreams, you’ve got schedules and things to keep track of—especially when it comes to Medicare.

This is why the Medicare program set up a site to help you say on top of all things health insurance. It’s called mymedicare.gov. We recommend it to our clients, and now we are recommending it to you.

Among other things, this site has some wonderful, time saving features including:

A Claim Library

Right on the home page, the site shows your most recent claims all the way back to claims made 36 months ago. In a three-column chart, the site displays

• What you were charged
• What Medicare approved and paid for
• What you might be billed (not considering your Medicare Supplement)

This is particularly helpful when budgeting for health care costs. If you know you’ve got a health care bill on the way, you can set aside some extra cash to pay for it. Otherwise, you might be caught unaware.

It is also helpful for detecting Medicare Fraud. If you start noticing claims in your claim library for services you never received, it is time to report fraud. You will be doing yourself and your country a favor by turning the bad guys in.

Your Current Plan Information

The site also shows you relevant information about your current health care plan including your prescription drug plan and any supplemental insurance.

This is really useful around the Annual Enrollment Period. Knowing the plans you have in place is the first step in deciding if you want to switch and what you want to switch to.  (Click here to read our thoughts about shopping around.)

Your Deductible Status

Under the “claims” tab, you can click on your deductible status link and find out how close you are to meeting your deductible. After you meet your deductible, plan benefits will begin. This is why your deductible status is important. You’ll have an idea what a service is going to cost before you receive it.

Your Preventative Care Scheduling

Medicare alone covers a lot of preventative services such as screenings and tests and certain types of counseling. They cover them in full, so you don’t have to pay a dime! Some are offered ever 2 years, some every 4, and some only every 6 or more years. It is difficult to know which ones you are eligible for on which years.

The preventative services page under the “my health” tab shows exactly what you are eligible for at any moment. This makes it extra easy to take advantage of the preventative services that are available to you. You’ve paid into Social Security for all those years for the benefits, so you might as well use them!

And overall, I think the best part of the site is that it is all in one place. Most—if not all— of the information you need to know about your health care is organized and at your fingertips. For the retiree like you who still has a lot going on, it’s a wise choice.

Have any concerns about your current plan? Looking to switch? Call Seniormark at 937-492-8800 to set up a free consultation.

6 60’s Theme Songs That Will Make You Nostalgic

As I was browsing the theme songs of the shows I used to watch when I was a younger kid (I do not identify as an adult yet), I realized how much I love nostalgia. Just a few notes and I was back in my pajamas on Saturday morning, watching my favorite TV shows.

So, instead of keeping this all to myself, I decided to rewind an extra thirty or so years from my era and get the baby boomers involved. Why leave all of you out of the fun? You guys had some excellent TV shows, and I want to let you relish those memories. Whether you watched them with your kids, as a kid, as a teen, or last week on MeTV, Let’s get started! Click the headings; hear the themes.

1. The Addam’s Family

Audiences and Halloween partygoers alike have been snapping along to “The Addam’s Family” since the show first aired in 1964. With cold, black and white stares, Morticia, Gomez, Wednesday, Uncle Fester, Lurch, Pugsley, and Grandmama welcomed you into their dark and sinister sitcom—Kookiness and spookiness and all.

Memorable Lyric: “They’re creepy and they’re kooky, mysterious and spooky. They’re all together ooky: the Addams family.”

2. My Three Sons

It is not nearly as iconic of a song, but it is definitely worth a mention. This bouncing, swinging theme was penned by Frank Devol. My Three Sons is about a widower named Steve Douglas and his adventures raising…well…his three sons.

Fun Fact: Did you know that Frank Devol also composed the Brady Bunch Theme?

3. The Flintstones

A classic Hanna Barbera tune, this theme (written by Hanna, Barbera, and Curtin) is strongly associated with the Flintstones. But did you know that “Meet the Flintstones” wasn’t the song that originally presented the modern Stone Age family to the world? According to neatorama.com, the animation was introduced by a lyric-less theme song entitled “Rise and Shine” for its first two seasons.

Memorable Lyric: “When you’re with the Flintstones, have a yabba dabba doo time. A dabba doo time. You’ll have a gay old time.”

4. The Andy Griffith Show

It’s just whistling, snaps, and a simple drumbeat, but those are the only tools “The Fishing Hole” needs to become a tenacious earworm. Originally composed and whistled into existence by Earle Hagen, I know it will be stuck in your head all day!

Fun Fact: Did you know that this song has words? Here is a link to a recording of Andy Griffith himself singing the little known lyrics.

5. The Dick Van Dyke Show

One thing that this show has in common with The Andy Griffith Show (other than the creativity of its name) is that The Dick Van Dyke show’s theme also has little known lyrics. Here are a few lines: “So you think that you’ve got trouble. Well trouble’s a bubble.
So tell old mister trouble to get lost.” Listen to it and try to sing along with the words. It’s easy once you get the hang of it.

Fun Fact: I know this has little to do with the song, but did you realize that Johnny Carson almost got the lead role, taking Dick Van Dyke’s place (Mental Floss)?

6. The Beverly Hillbillies

This song is as hick as you can get, and you’ve got to love it for that! With a banjo and some booming bass vocals, this theme narrates the poor family’s path to riches and their journey to Beverly (Hills, that is)!

Memorable Lyric: “And then one day he was shootin at some food, and up through the ground come a bubblin crude. Oil that is, black gold, Texas tea.”

Well…Unlike TV today, it wasn’t always 24 hour programming back then. So, in honor of that simplicity, I would like to end with the static, the blip, and the lingering white dot.

I hope you had a gay old time.

Turning 65 soon and not sure what to do? Call our office at 937-492-8800 for an appointment to help guide you through the process. No high-pressure sales pitches here, just in-depth discussion about the ins and outs of Medicare!

What Does a Medicare Supplement Really Cover?

Everyone will say, “It fills in the Medicare coverage gaps” or “it covers what Medicare doesn’t” In fact, I’ve said those mantras to my clients many times. But when you’re looking at paying $80-150 in premiums per month for one of Medicare’s more popular and comprehensive plans, that’s not enough of an explanation.

Retirees like you have a lot of things pulling for your cash. And when you’re living post full-time employment, money can be tight. It can even leave you wondering if a Medicare Supplement is really worth it. For that reason, I think it’s time to take a closer look and see what that monthly premium is really paying for.

I have addressed Medicare’s most costly coverage gaps below. Do the most popular Medicare Supplements (F, C, G, D, and N) pay for them?

20% Coinsurance on Part B

For outpatient coverage like lab tests, doctor visits, and surgeries (any care received while not admitted to a hospital), Medicare covers 80% of the costs. A Medicare Supplement picks up where Medicare leaves off, taking care of the other 20%. The only popular plan that doesn’t cover the 20% in full is Plan N, but Plan N only leaves a couple small copays of $20 for office visits and $50 for trips to the emergency room.

If you are thinking of a $100 x-ray, the 20% isn’t a big deal. But what about a $20,000 outpatient surgery? What about $150,000-200,000 on chemo-treatments, like my father-in-law experienced? Then you start to understand why this is such an important benefit.

$1340 Part A Deductible

Before Medicare pays anything on inpatient care, you have to meet a $1340 deductible, sometimes more than once per year. All of the popular Medicare Supplement policies cover the Part A deductible in full.

Hospital Coinsurance

Medicare pays for the first 60-days of your hospital stay (after the $1340 deductible, of course). However, you will have to pay $335 per day for days 61-90 and $670 per day for days 91 and beyond (these days do not necessarily need to be consecutive.) Again, all of the popular Medicare Supplements cover this in full.

Without a Medicare Supplement, a 120-day hospital stay would cost you over $30,000 in out-of-pocket costs!

Skilled Nursing Coinsurance

Medicare pays for the first 20 days. For days 21-100, you pay $167.50, and for 101 and beyond, you pay all the costs. Yet again, all of the popular plans cover every dime of this coinsurance amount for days 21-100.

And all of these benefits are just the foundation of what makes a Medicare Supplement such an attractive option for retirees. Many plans cover a lot more than what I’ve addressed here. For instance, a Plan F (Medicare’s most comprehensive and popular supplement plan) covers, well, almost everything. Assuming a procedure is Medicare approved, you will have no out-of-pocket expenses with a Plan F.

That is why, although they are not right for everyone, I often recommend them to my clients. They really do “cover what Medicare doesn’t” and “fill in the Medicare coverage gaps,” as it has been said so many times. Of course, no one wants to pay the monthly premium, but in the end, you get what you pay for. For most retirees, the peace of mind to know that they will never get stuck in one of those huge Medicare coverage gaps is worth it.

Have more questions?  Sign up for our next workshop at https://seniormark.com/workshops/ or call Seniormark at 937-492-8800.  We offer the answers to these questions and many more!

Medicare Supplement Insurance: Are You Insurable?

If you are in your Medicare Supplement Open Enrollment Period, you are 100% insurable, no questions asked. If you are in a guaranteed issue period, some plans may not be available to you but—again—you are 100% insurable. Still no questions asked.

But even if you are not in one of these two groups, it is likely that you will be able to get on a plan anyhow. You will have to undergo some health evaluation questioning, but that doesn’t mean your less than perfect health will prevent you from getting the coverage you need.

Lower Your Expectations

You’re 65 or older. Insurance companies don’t expect you to be able to land a round off back hand spring or have an empty medicine cabinet or even have decent cholesterol. In fact, I am looking at the most recent application for AARP Medicare Supplement Insurance, and they do not ask anything about blood tests or weight or most resolved issues. This is typical across most applications.

The only thing they look for is that you don’t have any “big-ticket” pre-existing conditions or alarming circumstances on your health resume: cancer, upcoming surgery, Alzheimer’s disease, etc. In short, they are looking to answer this question: is your health stable? They are not concerned with whether your health is particularly impressive.

Two Examples of Supposed “Uninsurables”

This week a client of ours called in who thought she was uninsurable because she had cancer 4 years ago. But this just wasn’t true. In fact, most insurance companies will offer you coverage if you have been cancer free without treatments for two years. After we assured her of the good news, she was promptly put on a great plan for her needs.

We also had another case of a man who just had a stent put in 1 year ago. Although he thought this would make it difficult to find a provider, this wasn’t the case either. We shopped some Supplement plans for him and found him a plan that still insured people with stents as long as it wasn’t put in within a year.

Concluding Thoughts

The goal of this post is not to deceive you into thinking that no one is uninsurable, but I do want to give those people with imperfect health some hope. Even pre-existing conditions as bad as diabetes can be insured. There are a lot of insurance companies out there, so shop around. Chances are one of them will take a chance on you!

Limited Time Offer

In fact, right now we have a company offering their Medicare Supplement policies with no medical underwriting!  That means even if you are affected by some of the above, they will not look at your health history before insuring you.  This is a limited time offer, so you may want to call our office for details if you are interested.  An additional bonus of this plan is that it offers the Silver Sneakers benefit!

Need help finding a Medicare Supplement for your unique situation? Looking for a licensed expert with a passion for assisting retirees? Contact Seniormark at 937-492-8800 for a free consultation.

Don’t Make One of These Common Medicare Mistakes!

The whole process of switching from your employer plan or private insurance to Medicare is fraught with potential costly mistakes. Misconceptions can leave you without much needed insurance. Failure to take the essential steps on time can leave you in the jaws of lifelong penalties.

After working in the Medicare industry for over 20 years, I see the same common goofs over and over, ones that cost people an arm and a leg. That is why I feel it is necessary to address them. Hopefully, this post will keep you on the straight and narrow, avoiding the misconceptions and missteps so many fall prey to.

Without further ado, let’s dive right in!

1. Not Signing Up For Medicare When You Turn 65

“I’ll take care of that Medicare enrollment stuff later.”

Don’t procrastinate when it comes to Medicare planning. A couple weeks can easily turn into a couple months and then, next thing you know, it is a year or more later and you’ve missed the Initial Enrollment Period (the 7-month period surrounding your 65^th birthday month).

It doesn’t seem like a big deal until you look at the penalties. Let’s just take a look at the Part B penalty alone, which is a 10% premium increase for every year you could’ve had Part B but didn’t sign up. This doesn’t sound like a lot, but if you are one year late and live another 20 years (a rough life expectancy estimate), you can easily pay over $3,000 in penalties. This is definitely a mistake you want to avoid!

2. Not Signing Up For Part B Because of Retiree Insurance or COBRA

“Why would I want to pay for Part B if my retiree insurance provides my coverage?”

While it is true that you can delay Part B if you have coverage through active employment, retiree insurance and COBRA don’t count. If you aren’t continuing to work past 65, you can’t delay Part B. Period.

If you do choose to delay, check the Part B penalties in the above section. They will apply to you, and they aren’t good!

3. Getting on the Same Drug Plan as Your Husband or Wife

“We’ve got matching tattoos, matching drug plans, and a joint Facebook account.”

You can get matching tattoos, and although I question the joint Facebook account, I can let that slide too. But you absolutely can’t get matching drug plans, even if your husband or wife’s plan is low premium.

Why?

Because every drug plan is different. They each have different preferred pharmacies, different copays, and—this is the important one—they cover different drugs at varying rates. So, even though it might seem convenient to get on the same plan, your drugs may not be covered by his or her plan. This may not be a big deal for a simple blood pressure medication, but prescription drugs are often expensive. Leave the wrong drug uncovered, and it could break the bank and shrink the nest egg.

4. Not Getting on a Part D Drug Plan at All

“I’m not on any expensive medications right now, why do I need one?”

The key words in that quote are “right” and “now.” You may be able to get your prescriptions for a small copay now, but—as I said before—what are you going to do if a drug costs $400 or much more a month? If you wait, you will still be able to get on a plan outside of your Initial Enrollment Period (IEP), but not without a Medicare Part D late enrollment penalty. And, since you can only make changes to your Medicare health insurance plans during the Annual Enrollment Period (October 15- December 7), you will have to pay for your expensive drugs out-of-pocket until that time.

5. Thinking Original Medicare Alone (Parts A and B) Will Cover All Your Health Insurance Needs

“Medicare is all inclusive, right?”

Medicare provides good coverage, but it doesn’t cover everything. Extended hospital stays, some skilled nursing care, 20% coinsurance on all outpatient services are just a few of the bigger expenses that will be left up to you. Other smaller ones include vision, dental, or hearing aids. Although I wouldn’t worry about those last three small ones, the bigger ones can be potentially disastrous. Why? Because there is no out-of-pocket maximum in Medicare. No matter how high the out-of-pocket expenses get, you are still on the hook.

That is why you need to get something to supplement Medicare alone. You don’t need to pay out the nose to get the most comprehensive coverage, but you can’t leave yourself vulnerable. You have lots of options from plans that cover almost everything to $0 per month Advantage plans that—although are often a hassle—do cap out your out-of-pocket spending at $4-6,000 per year.

6. Accidentally Missing the Medicare Supplement Open Enrollment Period or Your Initial Enrollment Period for Advantage Plans

“Oops…”

The time to buy a Medicare Supplement is during your open enrollment period, a 6-month period that starts when you turn 65 and enroll in Medicare Part B.

The time to buy an Advantage Plan is during your Initial Enrollment Period, a 7-month period that begins 3-months before your 65^th birthday month.

You can get on an Advantage Plan during the Annual Enrollment Period (October 15- December 7) if you miss the deadlines, but that can be problem if you need the insurance right away. What if you’ve got some big- ticket medical expenses before the end of the year?

And, with Medicare Supplements, although you can try to get on one anytime of year, there is no guarantee you can get one at all. You will have to undergo medical underwriting, and—if you don’t meet their requirements—they will deny you coverage. Now, you don’t have to be in perfect health to meet these requirements, but for some the underwriting can be a real problem.

7. Trying to Do It All Alone

“This can’t be too hard, can it?”

Let’s face it: Medicare is complicated. It is a convoluted government program serving over 50 billion beneficiaries. There are lots of deadlines and rules—as you can see—many opportunities for blunders. At Seniormark, we’ve seen people baffled by Medicare again and again, even people who’ve spent their entire lives in the health care industry! You should definitely educate yourself so you understand your options and don’t get taken advantage of, but at the end of the day, don’t do it all by yourself!  Sit down with a professional who will help ensure you aren’t making any mistakes!

Don’t do it alone this Annual Enrollment Season!

We can sit down with you and guide you through the whole process. Call Seniormark at 937-492-8800 or click here for a free consultation!