Tag: Medicare

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 Answers at a Glance: Should I Delay Part B?

Posted on September 22, 2016 by - Medicare, Retirement Planning, Uncategorized

Medicare Answers at a Glance: Should I Delay Part B?

 

Medicare Part A is free, so there isn’t much hesitation to enroll outside of HSA contribution issues. But with Part B, there is a $121.80 associated premium, so those approaching 65 are a little bit leery. Do I really need it?

 

Let’s make this clear: most people do. So before you make the decision to opt out, make absolute sure that you are one of the few who don’t!

 

You should NOT delay Part B if…

 

1.  You are retiring from work.

Retiree insurance or COBRA doesn’t count. If you don’t have employer insurance through active employment, the answer is simple: don’t delay Part B. You will be left without outpatient coverage for as long as don’t enroll, and you will incur penalties if you sign up late!

2.  Your employer’s health insurance plan covers 20 or less employees.

Just because you have employer insurance and are still working does not give you an all-access pass to opt out of Part B. If the plan doesn’t cover at least 20 people, you should definitely enroll in Part B. But take careful note. The number of employees is not always the same as the number of insured employees. Some temporary or part-time workers may not be covered on the employer insurance plan. Check with your employer before making any hard and fast decisions.

3.  Your employer insurance is more expensive

This may seem obvious, but I felt compelled to include it. Just because you can delay Part B doesn’t mean you want to. Analyze the costs and benefits of both Medicare and your employer insurance to determine which is the better value.

 

If these three criteria don’t apply to you, you may very well qualify to delay Part B. But I always recommend running your situation past a Medicare expert to make sure. Retirement decisions are as complex as they are important. Get help when you need it!

 

Need Medicare questions answered? Download our free guide, “Introduction to Medicare”.  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!