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Randy's Blogs

Don't Believe the Hype about Plan F...

March 20, 2018

We are seeing substantial misinformation in the marketplace concerning the beloved Plan F, enjoyed by many Medicare age people. Unfortunately, many have taken the news of Plan F’s eventual removal from the Medicare menu of products to mean that it will become unavailable for all, regardless of those who have it or not in the next few years.

To some degree, I think it may be just a misunderstanding from an agent standpoint, as many are claiming it is going away and scaring people off and on to Plan G prematurely.

The fact is anyone who is old enough for Plan F now will always be able to retain it under the current rules, until they pass away. Plan F is slated for obsolescence with those who are turning 65 after 2018. Those who have the plan currently can keep it. Simply, those born after that date will not be able to sign up for it. Plan F will eventually vanish off of the product menu of many insurers, as fewer and fewer will be eligible to purchase it.
As a rule, even if someone currently doesn’t have Plan F now, they will be eligible to buy it even after 2018, of they were born before 1953.

Oops, Mom Has No Insurance!

March 19, 2018

It happened again…a Blue Cross Blue Shield of Michigan Legacy customer did not pay her bill because of a caregiver oversight. In this case, we believe the caregiver had an unfortunate illness herself and forgot to pay mom’s premium.

The facts: Mom is 89 and lives in northern Oakland County and is currently without coverage. BCBSM Legacy Plan C is not willing to reinstate her plan.

Fortunately, she was able to answer medical questions and was approved for another Medicare Supplement policy from United Healthcare / AARP. Health Alliance Plan was also able to accept her to one of their Medicare Supplement Plans. Some beneficiaries are not so lucky, as they are unable to answer medical questions and obtain new coverage during the year. They would likely go bare without any coverage but original Medicare until the annual enrollment period. During which time, they could be signed up for a Medicare Advantage Plan.

Result: Happy ending! Mom will have insurance again in April and will be paying less than before on her Medicare Legacy plan.

Moving and How It Affects Your Medicare Advantage or Prescription Drug Plans

March 19, 2018

We often receive several calls and emails from participants who are losing their Part D or Medicare Advantage coverage when moving back to Michigan from another state. We routinely assist them in securing coverage mid-year. Here are couple of examples:

Case Number 1:
Recently, a couple moved back to Michigan from the Silicon Valley in California. As a result of their move, they lost their Part D coverage and also suffered a rate increase on their Medigap/ Medicare Supplement plans. We were able to switch their Medigap plans to a more competitive policy and establish new Part D plans for them as well.

Case Number 2: 
A frantic son called us regarding his mother moving back to Michigan. She was losing her Medicare Advantage issued by the state she lived in prior to moving to Michigan. Her current Medicare Advantage plan refused to pay for her treatment now that she had moved “because it was out of their service area”.

The Medicare rules read that once an insured moves out of the service area “sometimes even within state borders”, a participant must obtain a plan within their new service area. Availability of Medicare Advantage plans not only vary state to state but also vary within different counties as well.

If you notify your plan before you move, you may switch plans the month before or the month you move and continues for 2 full months after you move. If you notify your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months afterward.

We are eager to help regardless of the situation. Ideally call us before or after your move and we can help you establish a new plan. We carefully study pharmacy needs as we recommend plan changes so send us your drug list.

BCBS Legacy April 18 Increase

March 19, 2018

Our phone is ringing off the hook with customers and prospects that are disappointed over their new higher rates for the BCBS Legacy Plan C. Blue Cross Blue Shield of Michigan has elected to raise rates on both customer types, those who are over 65 with Medicare A & B and those who are under age 65 who are disabled, with Medicare Part A & B.

Presumably, Blue Cross Blue Shield of Michigan is still experiencing “unfortunate underwriting losses” on their historic Legacy product. You may recall that in 2017, Blue Cross Blue Shield of Michigan raising the rates from approximately $134 a month to a new premium rate bases on age, sex, and geographically location. Some customers, such as males in Oakland county over the age 80, so their rates rise from $134 per month to nearly $299 a month. Others pay somewhat less but everyone faced the large rate increase last year. The increase was supposed to assist with the nearly $200 million per year underwriting loss that BCBS was experiencing. Part of the loss was due to the state of Michigan, mandating that Blue Cross Blue Shield keep the rates very low and “vastly under market”.

In fact, the majority of customers that experienced the rate increase did not move and payed the increased premiums. Unfortunately, it doesn’t appear that the rates are adequate to cover the losses that Blue Cross is experiencing.

Right Now

As of April 1, 2018, Blue Cross Blue Shield is raising rates about 4%. Some of these seniors are going to be charged over $300 a month. The new rate will be based on age, sex and zip code. Rates will also be rising even more for disabled individuals with Medicare.

What to do?

Strategy 1:

Consider moving to another Medigap / Medicare Supplement plan in April. Most people over age 65 should apply to other Medicare Supplement providers to obtain lower rates. Medigap or Medicare Supplement policies do not follow the same rules as Medicare Advantage plans and maybe applied for any month of the year. Following this logic, participants may change insurance companies any month provided they pass underwriting for the new insurance company.

Many are surprised we can find them a company who will approve them at a better rate midyear. There is no risk to apply to see if someone can get approved or get a firm price. We commonly give people an idea of their perspective price just with a few questions over the phone. Should this be successful, some will save hundreds of dollars per month. Since health conditions are a key factor when considering moving to other Medigap /Medicare Supplement plans, participants should not procrastinate. Health conditions could change for the worse, therefore prohibiting the move to another carrier.

Strategy 2:

Some will not be able to move Medigap or Medicare Supplement plans at this time due to a temporary health challenge, however, they may reapply when they become healthier. Should their health not be likely to improve, they can pay the increased premiums on their Legacy plan until the end of the 2018 plan year and consider moving to a Medicare Advantage plan “MA” during the annual enrollment period.

Why these individuals should consider MA?

Competitive premiums
No medical questions to apply
No extra charge for advanced age as with Medigap plans
No extra charge for those with disabilities that are under age 65.

Things to verify before potential change

Those that elect Medicare Advantage plans will need to pay attention to how their pharmacy needs will be covered under these plans. Also, many of these plans have provider networks that must be scrutinized as well. While many doctors accept Medicare Advantage plans, potential insureds should verify their doctors are in network.

Call us to discuss your options or options for your parents. We will assist you to determine if a new Medigap / Medicare Supplement plan is a possibility. We can also help with a pharmacy study to make sure that medications will be covered under a Medicare Advantage plan or a Part D plan.

Strategy 3: Do nothing and pay the rate increase

This has been the most popular decision regarding Blue Cross Blue Shield of Michigan Legacy rate increase. The vast majority of participants on the Medicare BCBSM Legacy plan have not moved and are just paying the rate increase. The Legacy plan is a very good insurance plan and it works well for participants. Anyone who has experienced claims finds it to be a very good coverage. Unfortunately, the rates may continue to increase, especially as underwriting losses increase.
Should this happen, eventually, some will find it makes sense to consider other options as rates could increase year after year.

What will be your strategy??? Call us should you wish to explore your alternatives.

Moving Mom or Dad Closer to Home

February 8, 2017

We received a call yesterday from a daughter of a Senior citizen who is being moved to Michigan so that the family can better deliver care to her.

This is the second case we’ve had recently whereby seniors are moving into Michigan to be cared for by their children.

When this happens, the likely result is a loss of healthcare and/or prescription drug coverage by the senior. Under Medicare Part D ‘”Drug” and Part C “Medicare Advantage”, their plans likely terminate because a change in zip code. In other words, if the senior moves out of the service area they will lose their coverage and will need to select a new Medicare Advantage Plan C or Part D Prescription Drug Plan in their geographic area.

In the cases we’ve dealt with recently, seniors were moving from Ohio to Michigan, to be with their children. The daughter that called our office yesterday is moving her mother into an assisted living facility near her home, and will need to establish a new Medicare Advantage Plan within 30 days of mom’s move to Michigan.

Hoover and Associates in mind if you need help with such a move, or know someone who is moving their loved one to Michigan. We are happy to help you determine the best course of action before the move. The potential change of Medicare Advantage and Prescription Drug coverage is just one more thing to consider and an aspect of the move that is important not to be overlooked.

BCBS Legacy Effect on Disabled

August 26, 2016

The Blue Cross Blue Shield of Michigan Legacy rate increase is continuing to generate a substantial amount of traffic at our office. Disabled people and their caregivers are particularly interested in alternatives as they are alarmed by the substantial rate increase.
Recently, a woman who “Googled” us stopped in and spoke about her disabled husband. They are reeling from the potential rate increase and will be meeting with us to discuss alternative strategies.

A disabled man, who we helped sign up on Legacy, is dismayed by the price yet concerned other plans may not allow the same access to physicians he’s enjoyed. For a brief time, while disabled and before he met us, he was on a Medicaid plan. During his brief stay on the plan, he realized he could not see any of the doctors he has enjoyed dealing with in the past. We helped him exit off during open enrollment onto Legacy and a PDP.