Will I automatically be enrolled in Medicare when I turn age 65? 

June 22, 2021

That may be one of the most popular questions that we field every year. This is because, for many people, the Medicare journey is one of experience and anecdotes from friends. Some people are automatically enrolled in Medicare when they turn 65 because they already collect Social Security. Many people believe this is true in all cases; however, it is merely a myth that needs busting.

Medicare recipients who are automatically enrolled make the process appear effortless to their friends- "makes sense they turned 65 and were automatically signed up for Medicare." The people in this group took action that changed their fate. They elected their Social Security retirement benefit at age 62 or older and were automatically enrolled for Medicare Parts A and B at age 65.

What could be easier? Your Medicare card shows up in the mail, and the government sends you a letter and asks if you wish to retain it. Some people may waive Part B and keep Part A if they have other medical coverage from a group that has over 20 employees. Should someone accept the Medicare Part B coverage, it will cost approximately $148.50 for most enrollees in 2021. Part A generally has no charge if someone has been employed in the United States for approximately ten years or longer.

As mentioned above, some people can delay paying for and receiving Part B if they have employment-based health coverage from either their employment activity or the spouse.

If they are covered under a marketplace plan, an off-marketplace plan, or COBRA, they will have to sign up for Medicare Parts A and B when they turn 65.

Procrastinators beware. Signing up after the third month following the month you turn 65 subjects you to a late enrollment penalty that increases your premiums for the rest of your life. We've seen many cases where people do not sign up for Medicare on time and have extremely unfortunate health claim consequences. You will also need Parts A and B  if you wish to sign up for a Medigap or Medicare supplement plan or a Medicare Advantage plan.

In summary, signing up for Medicare Parts A and B is automatic if you claim Social Security before age 65. Otherwise, you must take action on your own by signing up three months before the month of your birth as you're turning age 65.

There's no need to take on extra stress or risk if you or a loved one are navigating the Medicare maze for the first time- please call our office. We look forward to serving you as you make your way through your Medicare journey. 

New Year, New Plan: How to Maximize Your New Health Insurance Coverage this Year

February 4, 2021

Many of us are relieved that it is finally 2021! The start of the new year may also mean that if you selected a new plan during open enrollment season, it became active on January 1, 2021.

If you have not already, the start of year is a great time to review your plan and its benefits. This can prevent you from incurring any unexpected co-pays and out-of-pocket expenses. Additionally, many plans offer preventative services and screenings at little or no cost to you. Utilizing these preventative services may save time and money long term by discovering any potential health irregularities and concerns early. You may even find it beneficial to schedule appointments early so that you can maximize your benefits. Although it is important to get a head-start on health, you should always refer to your doctor to determine the right care plan for you. Remember, it’s not too late to make the new year’s resolution to prioritize your health this year!

In addition, now is a great time to verify that you have received your insurance or drug card, are being billed the correct amount, and that you have adjusted your budget for your new plan. However, if you are experiencing any difficulty with a new or existing health insurance plan, as always, please reach out to our office and we will be happy to help.

 Wishing you health and wealth and a joyous new year!

Medicare Advantage Plan Coverage... How It Works While Away From Home

January 7, 2021

How will a Medicare Advantage plan work if I have an emergency away from home, while visiting family or on vacation?

That’s a very common question and concern from Medicare beneficiaries when considering a Medicare Advantage Heath plan.

In most cases, Medicare Advantage plans will cover your care if you obtain emergency services or if you are taken by ambulance, while away from home.  In many cases, the hospital may not be part of your plans provider network.  Most plans have a cap on how much you could be charged for the visit.  A typical co-pay could be as much as $150 to $200 for an emergency room co-pay.  Your Medicare Advantage plan materials will detail in and out of network provisions.

If you need continued care while you are out of town, your Medicare Advantage plan will usually request that you are transferred, once you are stable, to one of its network hospitals.

Should the physicians treating you at the out of network hospital deem that you are not able to be transferred because your conditions aren’t stable, the Medicare Advantage plan will have to pay for the care you need until it’s safe for you to be moved to an in network facility. 

The time to know how how these provisions work is before you need them. If you are unsure as to your coverage provisions, call your agent or insurance company for the details.

New Program for Renal Disease Patients

December 29, 2020

The United States Department of Health and Human Services Secretary, Alex Azar, said in September that about 1 in 3 Medicare patients dealing with end-stage renal Disease will be enrolled in a program that rewards them with more convenient comfortable options like home dialysis.

The program would not only be convenient but also curtail exposure to vulnerable kidney patients to COVID-19 by eliminating visits to clinics.

Medicare will begin increasing the amount of pay to its providers for home kidney treatments to encourage the change. The move will actually save Medicare about 23.5 million over five years.
The new regulation also increases government support for people to donate their organs, including financial compensation for lost wages, child care and elder care. In September, it was estimated about 92,000 Americans are on waiting lists for kidney transplants.

Source AARP bulletin November 2020

Medicare Annual Election Period

November 5, 2020

Our Medicare Annual Election Period season is off to a brisk start! Of course, we are busy with the normal Part D "Prescription Drug Plan" and MAPD "Medicare Advantage Plan” questions this time of year.  We have clients that may wish to switch from Medicare Advantage Plans to Medicare Supplements and vice versa. There’s something for everybody!

Your Action May Be Required:

• Minnesota Life's Journey Rx - This year’s open enrollment is especially busy because of the exit of a carrier from our market, Minnesota Life's Journey Rx.  Everyone currently on the Journey Rx plan must select a new plan with a different carrier for next year.

• Prescription Blue Preferred PDP -  Blue Cross Blue Shield of Michigan has dropped Prescription Blue Preferred PDP for 2021, their mid-tier plan, and increased the premium of their previously least expensive plan by nearly $50, Prescription Blue Select PDP. Needless to say, this may cause most clients to move to another plan.

Many of our clients have begun doing their own Part D studies on Medicare.gov and sending us the results for consultation, which is working out quite well. Thanks to all those doing their own studies! Although you may have already been contacted by our office, if you are on Minnesota Life's Journey Rx plan or Prescription Blue PDP Preferred in 2020, and are unable to complete your Part D studies, please contact our office and we would be happy to help you!

Medicare Plan Pricing... Why the difference in price?

October 2, 2020

The majority of our clients elect Medicare supplement plans as their coverage of choice when they turn 65 or leave the workforce to provide for their own health insurance, along with Medicare parts A and B.

 One of the most important determinates is often cost of the plans. We have found that it definitely pays to shop around. According to the Medicare plan finder tool, A 65 year old male, aging into Medicare and  living in Royal Oak, MI, where our office is located, would have a plan G premium that could vary from $122/month to $362/month. The rates quoted would be for plan G each having identical coverage at the time of service. We see this variance in rates happening in all of the states where we are licensed, whether Ohio, Florida, or Michigan, it’s important to compare.

 This wide rate variance causes our office to answer the following question. Why the difference in price?

Perhaps some Insurance carriers are charging more because they must have higher cost structures or desire better profit margins? Some plans also, no doubt, will have different underwriting questions and qualification standards. Sometimes it comes down to scale. The largest carriers in a state are often able to negotiate better rates and therefore are often most competitive. Other times insurance companies may have a strategy were by they are taking on new business only at a price where they can be profitable, where others are willing to take on risks on a more aggressive basis.

 Our clients know that a secondary concern, beyond a competitive starting price, is the rate stability that an insurance company exhibits years after the sale. In other words, once the policy is issued, how well does the original pricing hold up year over year through the renewals? Will they renew with a steady level rate increase slope or exhibit large swings and price fluctuations, at times as high as 30% upon renewal.  Sometimes a more aggressive carrier, who offers deep discounts at the start, will not be able to maintain the price as time goes on, and raises it on policyholders who choose to stay with the carrier.

That underscores why it is it is so important to requote yearly.

Final word on the price disparity?

In many cases we find the old adage "you get what you pay for" is not always true regarding Medicare supplements.

And so it begins…the 2021 Medicare season

August 18, 2020 

Believe it or not, just like the NFL, there’s a huge “preseason” to the Medicare Annual Enrollment Period (AEP). 

The 2021 Medicare season officially begins on October 15^th, however our preparations begin in early July. 

Insurance agents are required to be re-certified annually, completing training and certification exams regulated by the Centers for Medicare and Medicaid Services or “CMS”. 

With our CMS training out-of-the-way, we will now become re-certified with each insurance company that we plan to represent in 2021. 

Our Medicare team has attended product training sessions with the following carriers:  Blue Cross Blue Shield, Health Alliance Plan, Aetna, United Healthcare/AARP, WellCare, Humana, Priority Health & Silverscript.    

All of this preparation in the “preseason” makes our team well prepared and knowledgeable to serve our clients in an exemplary fashion!

Should I Stay or Should I Go… Medicare Part A & B

July 23, 2020

If you are approaching age 65 or over age 65, and are still working for a company with less than 20 employees, you have healthcare decisions to make that can result in thousands of dollars in potential savings or lost opportunities.

Of course, the decision I am referring to is whether to either stay on your employer health care plan or go off onto a Medicare Supplement and a Part D plan with Parts A and B, or a Medicare Advantage plan.  Note that the decision to get Part A & B won’t be yours.

If you work for a company with less than 20 employees, in most cases, Medicare will be primary for your health care needs and your group carrier will be secondary.  For many people, the cost of a Medicare Advantage plan with prescription Rx or a Medicare Supplement with a Part D Prescription Drug Plan will probably be less than the total premium for the employer group insurance. 

 The big determinant is, who’s paying the premium? 

If you are paying the premium, perhaps through payroll deductions, it may be much less expensive for you to exit this coverage.  If your employer is paying the entire cost of the health insurance, it’s likely to be more advantageous to stay on the employer health plan.  However, you will need Medicare A & B in either case.

Prescription drug costs can be the largest single variable in determining whether it makes sense to stay on an employer health plan or opt off and enroll in a Medicare Advantage Prescription Drug Plan (MAPD) or a Medicare Supplement and Part D plan.

To make the best decision, it is imperative that you assess your out-of-pocket drug costs should you stay on the employer plan and compare those costs to the out-of-pocket costs that will be experienced should you move on to a Part D plan or a Medicare Advantage plan that covers prescription drugs.

We recommend everyone does a Medicare Rx study available on Medicare.gov  https://www.medicare.gov/   If you’re unfamiliar with the process, we would be happy to assist you. 

Reasons to consider staying on an Employer Group Health Plan: 

• The employer is paying the entire cost of the insurance with no out-of-pocket cost to you.
• The employer plan is very strong and has very little out-of-pocket costs for both medical and prescription.
• Your spouse is not 65 and is currently covered on your coverage, preventing you from exiting.
• You determine through a Medicare Rx study that your out-of-pocket costs will be substantial

Potential reasons to opt off of your Employer coverage in favor of a Medicare Supplement and Part D Plan, or Medicare Advantage Prescription Drug Plan. (MAPD) 

• You take very few prescription drugs and will face little out-of-pocket costs on your Part D Prescription Plan or MAPD.
• The employer plan is costly, as you have to pay much of the premium and out-of-pocket costs.
• You are on the plan as a single and do not have a dependent spouse under the age of 65.
• You may enjoy a greater choice of physicians with either a Medicare Supplement or Medicare Advantage plan.

One week ago, Michigan Auto Insurance Reform took effect.

July 10, 2020

As many of you know, I wrote a robust blog post on this topic last week, including charts that we utilized in our webinars  https://www.medigapformichigan.com/michigan-auto-insurance-reform-blog   We’ve also now posted the recorded webinar that you can view on our website. You can watch the video here:  https://www.medigapformichigan.com/michigan-auto-insurance-reform-links     You may easily share it with your friends who may benefit from the information.  Auto insurance reform has been a very confusing topic, as it presents many new risks for Michigan residents to be concerned about. 

Even today I received a call from one of our clients who was reviewing their new auto insurance choices for the following year. Don’t let the decision overwhelm you.  can help give you an objective look at all your options.

 Our team is ready for a year of questions.

 #medigap   #autoreform