Tag: Dan Hoelscher

Why You Can Try a Medicare Advantage Plan at No Risk

Posted on November 1, 2016 by - Medicare, Medicare Advantage, Medicare Supplement

Why You Can Try a Medicare Advantage Plan at No Risk

Infomercials have done it for years. When people feel uneasy about trying a new product, they offer a free trial or a money back guarantee. It provides security for the buyer to know that even if the supposed benefits of a product were oversold or blown out of proportion, he can still send it back. There’s no risk.

 

Well, Medicare offers something very similar. It’s called the “Medicare Advantage Trial Right”.

 

A lot of people are uncomfortable with trying Medicare Advantage because they don’t want to feel trapped in a plan they hate until the next Annual Enrollment Period. The trial period takes this risk away. As long as it will be your first time enrolling in a Medicare Advantage Plan, you qualify for Medicare Trial Right! This means that—no matter what time of year it is—you can drop your Medicare Advantage plan with no penalty and enroll in a Medicare Supplement Plan. This “free trial” period lasts 12 months from the date the Advantage Plan coverage goes into effect.

 

But as the infomercial cliché puts so obnoxiously…

 

WAIT…There’s More!

Some people believe that if they have pre-existing conditions and get on an Advantage Plan, they will be denied switching back to a Medicare Supplement Policy based on their health. In other words, they think that if they give up their Supplement for an Advantage Plan, they will never get it back. But that’s where the “money back guarantee” part of the deal comes in. Regardless of health, the Medicare Trial Right guarantees that you will be able to get back on a Supplement, no medical underwriting involved.

 

It’s true that Medicare Advantage plans are alluring with their sometimes shockingly low premiums. But they aren’t always the right fit for retirees. They change unpredictably and can be quite a hassle. This is why the Trial Right is so beneficial. It allows you to try a plan on for size, and then toss it back on the rack. To test drive it around the block, and then park it in the lot if it doesn’t meet your standards. And all the while, it guarantees that your old, trusty Medicare Supplement will be there.

 

Want to look into switching to a Medicare Advantage Plan? Call Seniormark at 937-492-8800 for a free consultation.

 

Other questions about what to do during Medicare Annual Enrollment?  Download our Annual Enrollment Checklist and you can relax when it is complete!

 

 

Don’t “Set It and Forget It” This Annual Enrollment Season!

Posted on October 18, 2016 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement

Don’t “Set It and Forget It” This Annual Enrollment Season!

 

Does anyone remember Ron Popeil? If you don’t, allow me to rephrase the question. Does anyone remember the “set it and forget it” infomercial king?

 

I bet it’s ringing a bell now.

 

I, for one, can still see him in his green apron, armed with nothing but some well-seasoned meats and a fancy rotisserie cooker, taking the cheesy and overly scripted infomercial world by storm: “All you have to do is…” The unrealistically enthused audience chants, “SET IT AND FORGET IT!”

 

He was like the Billy Mays of the 70s, but with food instead of cleaning products.

 

But I digress…back to the topic at hand. The reason I retrieved this slogan from memory lane is to make a point: Many people have the “set it and forget it” mindset with their Medicare Health Insurance Plans. They think that once they undergo the process of enrolling in Medicare, enrolling in supplemental coverage or an Advantage plan, and signing up for a drug plan that they never have to change anything again. Happily ever after.

 

But this just isn’t true. Yes, most of the work is done. And you’ve definitely done the minimum to get by. But there’s a good chance your situation will change over time. And, even if your situation doesn’t change, there is a very good chance your health care plans will, oftentimes drastically. This leaves you in an ill-fitting plan that doesn’t meet your needs or your budget. You may need to switch!

 

When it comes to Medicare Annual Enrollment, there is a reason for the season. From October 15—December 7, you have the opportunity to make strategic changes to your health care plans.

 

Here are 3 reasons you might need to make changes this year!

 

1.  The Medicare Supplement Creep

Medicare Supplements are typically consistent from year to year. The benefits are guaranteed to stay the same, and the premiums rarely increase drastically. But the premium cost almost always creeps up, dollar by dollar, slowly but surely.

 

If you stay on that ride for too long, you could end up paying $100+ more a month than you should. In fact, if you have been in the same Medicare Supplement Plan for 4-5 years, there’s a good chance you’re paying too much for it. Shopping around for a better deal this year could save you hundreds…and all without reducing your coverage.

 

REMINDER: You can change your Medicare Supplement any time of year, not just annual enrollment.

 

2.  The Advantage Plan Leap

There are so many aspects of an Advantage Plan that can frog around over time. The deductible may go up. The premium may go down. You might have higher copays. Your coinsurance might drop. And beyond benefits and price, doctors and hospitals may go in and out of your plan’s network. A doctor available to you this year, may not be available the next.

 

This is why it is important to review your plan. Is your family doctor still within the plan’s network? Is it still the best value for you? If you simply set it, forget it and let it skate by another year, you’ll never know.

 

3.  The Drug Plan Drop

A drug plan may vary in cost from year to year, but what you really need to check is the list of medications the policy covers, also known as the formulary.

 

Over the years, a drug plan may discontinue or reduce coverage on certain medications. Imagine if the drug it discontinued was your most expensive one, and you didn’t realize it. Yeah…it could be a financial disaster.

 

Review Your Plan This Year!

So make sure to take control of your health insurance options. Review your plans, and take careful note of all the changes. The “set it and forget it” philosophy might work well for cooking chickens, but it doesn’t work for this.

 

For your health insurance, I offer another slogan: If you set it and forget it, you might regret it.

 

Maybe that will catch on…

 

Yeah…probably not.

 

If you haven’t already downloaded our Annual Enrollment Checklist, there is no time like the present!  Make sure you have completed it — and then you can forget it — until next year this time!  Download it here:  https://seniormark.com/annual-enrollment-period-checklist/.

 

Looking to review your plans with a Certified Senior Advisor? Call Seniormark at 937-492-8800 for a free consultation.

 

6 Things Everyone Needs to Know About Their 2 Medicare Choices

Posted on September 27, 2016 by - Medicare, Medicare Advantage, Medicare Supplement

6 Things Everyone Needs to Know About Their 2 Medicare Choices

Medicare Advantage and Medicare Supplements. Two feasible choices. Two Medicare buzzwords. One startling misconception. And here it is: Medicare Advantage plans and Medicare Supplements are the same.

 

But this is just not true…not even a little. In fact, Medicare Advantage plans and Medicare Supplements are fundamentally different. So different that not knowing these differences could cost you…in convenience, in security, and in dollar signs.

 

So…without further ado…these are the 6 things you need to know about the 2 Medicare choices:

 

  1. Medicare Supplements pay secondary. Medicare Advantage Pays Instead.

The “street name” for a Medicare supplement is a “Medigap” plan, and it is a nickname rightfully earned. Medigap plans are called as such because they “fill in the gaps” of what traditional Medicare (Parts A and B) doesn’t cover. Therefore, you will have little to no out-of-pocket expenses. A Medicare Advantage plan doesn’t do this. It functions as an alternative for traditional Medicare. This means that—if the Advantage plan doesn’t cover it—you can be stuck with some pesky deductibles, copays and coinsurance.

 

  1. Medicare Advantage Plans have Networks. Medicare Supplements Don’t.

Medicare Advantage plans contract with specific hospitals and health care providers. And if you don’t go to their pre-picked “network” of providers, your share of the costs may rise. In some cases (especially out of state), the plan may not cover you if you receive care at a hospital outside of their network (except in the case of emergency)! Medicare Supplements allow you to go to any doctor or hospital you want as long as they accept Medicare.

 

  1. Medicare Supplements Don’t Change. Advantage Plans Do.

Since Advantage Plans are funded by government subsidies, their benefits are greatly affected by politics. The more money they can get from the government, the better their benefits and premiums can be. This means that plans will likely change from year to year and you may have to reevaluate, re-shop, and re-enroll in a different plan. Medicare Supplement plans are the opposite. Since the policyholder funds them, the plans are usually consistent from year to year.

 

  1. You Can Always Change to an Advantage Plan. You Can’t Always Change to a Medicare Supplement.

If you are in a Medicare Supplement plan, you can switch to an Advantage plan without any medical health questioning as long as it is during the annual enrollment period. It doesn’t matter if you have pre-existing conditions (with the exception of kidney failure); you will still be able to obtain coverage.

 

However, if you want to switch from an Advantage plan to a Medicare Supplement, it is not as simple. Although you can still enroll during annual enrollment, you will have to qualify based on your health. This can be a problem for those with pre-existing conditions. For instance, let’s say the government curbs their funding for your Advantage Plan. This raises the premium and lessens the benefits significantly. You have cancer. You can’t change to a Medicare Supplement because you couldn’t qualify based on health. What do you do? More than likely, you will have to stay with your unwanted Advantage plan!

 

  1. Medicare Supplement Have Premiums. Advantage Plans Have Low Or No Premiums.

While the average Medicare Supplement premium is up around $100-120 a month for a 65 year-old, the average Advantage plan premium is about 50-60. And (aside from your Part B premium) they may be completely free!

 

  1. Two Choices Can Quickly Become Two Hundred.

You only have two options in the beginning, but once you choose a route—whether Medicare Advantage or Medicare Supplement—it will likely multiply into many more choices. There are 11 supplements, 24 drug plans, and dozens of Advantage plans. Not to mention the other decisions you have to make regarding when and how to go about signing up for Medicare to avoid penalties. Like I always tell my clients, Medicare is a big animal. I always recommend consulting with a retirement advisor for help.

 

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!

Medicare: It’s as easy as A B C…and D

Posted on September 13, 2016 by - Medicare, Medicare Supplement, Retirement Planning, Uncategorized

The Jackson Five’s number one hit single in 1970 takes the convoluted topic of love and boils it down to a few letters. Sweet simplicity. “All you gotta do is repeat after me,” Michael sings, “It’s as easy as A B C.”

 

Well, I figured if the Jackson Five can make love easy to understand, the least I can do is attempt the same thing with the complexities of basic Medicare. So here goes nothing. Medicare: it’s as easy as parts A B C…and D.

 

Part A (Inpatient Coverage)

Part A is hospital insurance. A.K.A inpatient care. A.K.A healthcare coverage for any care received while you are officially checked in at a hospital. Beyond that definition, Part A also covers limited home health services, hospice care, and skilled nursing facility care. If you paid into Social Security for more than 40 quarters (10 years), then good news! Part A is provided at no cost to you.

 

Part B (Outpatient Coverage)

Part B is exactly the opposite, covering care received while checked out of a hospital. It covers services such as outpatient surgeries, diagnostic tests, lab tests, x-rays, and a laundry list of preventive services that are covered in full. Unfortunately, Part B does have an associated premium of $121.80 per month (in 2016), a fee which is adjusted for those of higher income (don’t worry…this applies to very few people).

 

Part C (Medicare Advantage)

Part C is a whole different ball game. So pay attention, it could get a bit messy. Although Part C is offered as a Medicare associated program, it actually replaces Medicare Parts A and B as the payer of your claims. As opposed to being offered by Medicare, it is offered by private insurance companies who have contracted with Medicare. It covers everything that Parts A and B covers and may even provide additional benefits such as drug coverage. However, you usually have to pay a separate premium to receive Part C.

 

Part D (Drug Plan)

Part D helps cover the bills for your pills! In other words, it is your prescription drug coverage. Like Part C, it is offered through private insurance companies. And like Part B, the premiums are sometimes (but rarely) adjusted for those of higher income. The cost is difficult to pin down because it varies so drastically from company to company. But—just to give you an idea—the average cost of a Part D drug plan is $34.10 (in 2016).

 

At Seniormark, we believe that the transition to Medicare does not need to be confusing and stressful. We would love talk to you about your options to get you in the right plan for your needs. Medicare may not be as easy as the Jacksons’ suggest, but that does not mean it cannot be made simple with the help of our trusted experts. So sit down and relax! Let us spell it out for you.
Not sure what to do next? To get you started, download our free guide, “Introduction to Medicare”. 

 

Call Seniormark today at 937-492-8800 for a free consultation!

Prescription Drug Assistance: Where to Get Help

Posted on August 10, 2015 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement

Here is a Helpful article that was recently in the Dayton Daily News.

By Marci Vandersluis

Contributing Writer

I recently visited with a couple that shared that they were having difficulty paying for some of their prescription medications. One spouse stated that some of their medications had very high out of pocket costs. These co-pays were affecting their ability to pay for some needed home repairs along with food purchases. While this article has no magic solutions on how to eliminate prescription drug costs, it should be of some relief to know that with a little perseverance, along with some web “surfing”, there are programs and services available directed towards providing prescription assistance to lower income older adults.

Since 2006, those eligible for Medicare have been encouraged to enroll in a Medicare Part D plan, which provides prescription drug coverage. The two ways to get coverage are either through adding drug coverage to original Medicare, or to enroll in a Medicare advantage plan that offers Medicare prescription drug coverage. Beneficiaries must first have Medicare A and/or B to enroll in a drug plan and must have Medicare A and B to qualify for enrollment in a Medicare Advantage Prescription Drug plan. It is important to note that while enrolling in a Medicare D plan, is voluntary, not signing soon after eligible or when other medical coverage (such as an employer sponsored plan) ceaseD-resized-600s will result in a monthly financial penalty that will continue through the duration of coverage.

Most have found that while the implementation Part “D” has provided significant cost saving, it continues to present some challenges for beneficiaries. One such frustration is the feared coverage gap or “doughnut hole.” In 2015, once the beneficiary and drug plan have spent $2960, the person is responsible for much higher of pocket costs for prescriptions. Once these costs reach $4,700 the beneficiary is only responsible for 5 percemt of prescription costs, for the remainder of the year. While Medicare is working on more discounts for those in the coverage gap with the ultimate goal of closing the gap in 2020, there are still significant costs while in the “ doughnut hole.” Monthly statements from your drug plan will outline explanation how much has been spent on medication and if you have reached the coverage gap.

Co-pays for some medications can be very expensive even when not in the coverage gap. Fortunately, for those who meet certain financial guidelines there are some programs to help with prescription drug costs. One such program is the Chubby Checker, Patty Duke, endorsed Medicare Extra-Help program. Individuals with income of approximately $17,655 yearly income ($23,895 for married couples), with resources of approximately $13,640 ($27,250 for married couples) should consider applying for this program as it can offer considerable savings. See below for the link to apply online. If there are additional circumstances, if only marginally above these guidelines, or even if in doubt regarding eligibility, it is encouraged to apply. The Medicare website also advises contacting and your specific drug plan to see if eligible for any type of extra help.

Resources

Ohio Benefit Bank-Consumer Hotline: 800-648-1176 or www.ohiobenefits.org

United Health Solutions: 937 220-6600 or www.uhs-dayton.org

Partnership for Prescription Assistance: 888-477-2669 or https://www.pparx.org

Needymeds: Helpline 800-503-6897 or http://www.needymeds.org/newuser

Ohio’s Best Rx: 866-923-7879 or http://www.ohiobestrx.org/en/index.aspx

Good RX-drug discount card: 888-799-2553 or https://www.goodrx.com

Drug companies that offer assistance:http://www.needhelppayingbills.com/html/get_free_prescription_drugs.html

Medicare information on lowering drug costs: 800-633-4227 or https://www.medicare.gov/part-d/costs/coverage-gap/ways-to-lower-drug-costs.html

Ohio Senior Health Insurance Information Program (OSHIIP): 800-686-1578 orhttp://www.insurance.ohio.gov/Consumer/OSHIIP/Documents/whatisoshiip.pdf

Medicare Extra Help: 800-772-1213 or www.socialsecurity.gov/extrahelp (Online application)

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 Policyholder Alert!

Posted on March 10, 2015 by - Uncategorized

postcard33Have you received this postcard in the mail?  Is it coming from Medicare?  Is it important information?  It does say, “REGISTERED DOCUMENT – DO NOT DESTROY.”  The truth is this is just a solicitation for insurance, and if you mail in the return postcard you are sure to get a call from an insurance agent, or worse yet a knock on your front door.  The unfortunate truth is we now live in a world of information overload and everyone is vying for your attention…yes, even me.  And in the world of Medicare, some lead companies resort to making the older population believe their mailing is more than it is.

If you look closely at the small print at the bottom you will read, “This information is not affiliated or endorsed by government agencies or the federal Medicare program.  You may be contacted by an insurance licensed representative.”  This disclaimer language is a sure sign that the mailing is a solicitation as it is required by Medicare.  I am not judging those who use these postcards to drum up business, in fact these cards are completely compliant with current regulations.  I just believe there is a better way…honesty!

Why can’t we replace the words, “REGISTERED DOCUMENT – DO NOT DESTROY” with, “THIS IS NOT A REGISTERED DOCUMENT – DESTROY IF YOU WANT…BUT IF YOU DO, OUR AGENCY WON’T BE ABLE TO HELP YOU!”  Why can’t we just get back to letting people know we are here to help when they need it.

Here is a great example:

https://www.youtube.com/watch?v=FrmYLo3tMA8

Medicare Solicitation

Posted on October 7, 2014 by - Medicare, Medicare Advantage, Medicare Drug Plan, Medicare Supplement

knockingIt has been brought to our attention (thanks to our clients) that several medicare supplement/medicare advantage agents in the area have been going door to door soliciting new business.

If you don’t know, it is illegal for an agent to stop at your door, or call you on the phone, without an existing business relationship.

If this happens to you, please do us and yourself a favor and let them know they are not allowed to solicit door to door. If they don’t agree, direct them to Ohio Administrative Code 3901-8-09, Section (D)(2)(a).

At Seniormark, we work diligently to follow the rules put before us.  If you are considering making any changes to your existing plans, give us a call before you do — we are happy to help!!!  (937) 492-8800.

 

 

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:

Capture

Feel free to comment below if you have any questions…