Tag: Dayton Ohio

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

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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 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!

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.