Tag Archives: independent agent

Medicare Beneficiaries, Shop, Shop, Shop!

Last month, I posted about how I am always reminding my Medicare Beneficiary clients that they are the Customer.  They should ask questions about procedures and how they can save money by doing so.  Another recent study validates this.

Researchers at the University of Pennsylvania Health System recently confirmed how much can be saved and how much transparency exists for medical procedure costs.  They gave an example of shopping around for a CT scan over a 3 state area and finding a cost variance from $437 to $2239!

Beneficiaries with a Medicare Supplement have less need to shop around due to the coverage.  But Beneficiaries with either Part C Medicare Advantage plans or those who only have Parts A and B, can benefit by checking around.

If you want to read more about this topic, you can go to the following link:  https://consumer.healthday.com/health-technology-information-18/cat-scan-news-88/out-of-pocket-x-ray-ct-scan-costs-vary-widely-710984.html

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

 

Proposed Changes to Medicare Payments

CMS, who manages Medicare, has recently announced some proposed changes to how Medicare reimbursements will be made.  These proposals are targeting such areas as:  Hospital Observations status, Physicians, Skilled Nursing Facilities, Part B drugs, etc.  The various proposals are accepting comments in June.  The main goal of the proposed changes is to reward better patient health and cost efficiency.

You can check back on this blog for updates once these proposed changes have been finalized or go to CMS.gov.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email address:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

Medicare Patients are the Customers!

I am always reminding my clients, especially my Part C Medicare Advantage clients, that they are the Customer.  They can and should ask how and where they can lower their medical costs.  If a doctor prescribes a test, they should ask why it is needed and more importantly, where can they get that test done that will cost them the least based upon the specific Plan they have.  Most of us are not accustomed to asking our doctors these types of questions.  We think “they are the doctor, they should know best.”  In many cases they don’t have any idea of the variances in costs for certain medical tests.  Costs vary widely based upon where a test is administered and which Plan a patient has.

This is less of an issue for my Medicare Supplement clients; however, this concept of asking, also applies to prescriptions.  As almost everyone has a Prescription plan (whether it is a stand-alone Part D drug plan or it is embedded in a Medicare Advantage Plan), there are many variables to lowering drug costs.  Here too, ask for lower cost alternatives such as Generics and shop around at different pharmacies.  A recent article describing proof that both doctors and patients are missing opportunities to lower costs is linked below:

http://khn.org/news/by-not-discussing-cost-issues-doctors-patients-may-miss-chances-to-lower-out-of-pocket-expenses/

The bottom line is Medicare Beneficiaries should get in the habit of asking questions regarding how, where and when they can save money when something is prescribed.  I do it and I recommend my Medicare clients do it.

Based in the Richmond, Va area, David Higgs of Choices In Medicare specializes in helping seniors transition to Medicare.  He can be reached at email:  David@ChoicesInMedicare.com or go to website:  www.ChoicesInMedicare.com

CMS Finalizes 2017 Medicare Advantage Payment

CMS has just released their 2017 Medicare Advantage plan capitation rate.  On average, the payment will increase by .85%.  You may recall that Medicare Advantage plans, also known as Medicare Part C, are one way Medicare Beneficiaries can get their Medicare.  This shifts the risk and responsibility for a Beneficiary’s Medicare claims from Medicare to the private insurance company offering the Medicare Advantage plan.

This slight increase probably means most plans will not have to change their benefits much.  We will know in October when all 2017 plans will be published.  The increases fluctuate from year to year.  If you want to know more about this news story, click on the link below.

http://www.bloomberg.com/news/articles/2016-04-04/u-s-increases-2017-medicare-advantage-rates-less-than-expected

If you have questions about Medicare coverages or the difference between Medicare Advantage plans and Medicare Supplements, contact me at:  David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com website.

Medicare Telehealth Bill

Earlier this month, a bipartisan bill was introduced in both the Senate and Congress to allow Telehealth services to be covered by Medicare.  The Medicare Telehealth bill would allow seniors to “see” a doctor from the convenience of their home via computer or smart phone device.  This could be extremely beneficial for seniors who are less mobile but have minor illnesses and just need a prescription.  Telehealth has been growing over the last few years and now could be extended to cover seniors.  It would be a “win-win” solution as it would save Medicare billions of dollars and provide conveniences to Medicare beneficiaries.  Stay tuned over next few months for progress on this bill.

To read more about this bill, click on the following link to the article:  http://www.bna.com/lawmakers-introduce-medicare-n57982066990/

We here at Choices In Medicare help people transition into Medicare.  If you have questions or need assistance obtaining Medicare Supplemental coverages, contact us at:  David@ChoicesInMedicare.com or go to our website at:  www.ChoicesInMedicare.com

Private Exchanges and Choices In Medicare

Many Retirees and other Medicare eligible beneficiaries will be directed to a Private Exchange to select their health plan benefits.  Typically, large employers and some large Benefits firms are getting into the Private Exchange arena.  The latest entrant is the financial services firm, Fidelity, who has announced this as a strategy.  A Private Exchange is similar to the Affordable Care Act Marketplace Exchange which was designed for people under 65.    An Exchange is merely a website that lists a person’s options and allows enrollment.  By itself, an Exchange is OK but there are some things anyone contemplating their options via an Exchange should be aware of.  I have reviewed some of the Exchanges and found a few common issues:

  1. The Exchange is going to be limited to a few plans from a few carriers. This means that there may be other options which could be lower cost that won’t be available.
  2. The people staffing the inbound phone lines are sometimes not experienced, independent Benefits professionals. Their knowledge can be limited to the training received for that call center role.
  3. Some of the information on the Exchange is either out dated and/or inaccurate.
  4. In many cases where the beneficiary is an employee, the employer contribution will only apply if the employee obtains their benefits through the Exchange. This could mean an employee must limit themselves to the Exchange options even though there may be better options available.
  5. The Exchange experience is not very personable. You are dealing with someone you don’t know in an unknown location.

So what is the alternative?  People like me usually allow you to avoid these pitfalls.  As an independent agent, I represent most or all of certain types of available plans.  For example, I represent all of the Medicare Advantage plans in Central Virginia and 7 of the largest, national Medicare Supplement companies.  In most cases, I can meet face-to-face and establish a better environment when making such important decisions and, at no cost to the client.

If you have questions about your Choices In Medicare, contact me at David@ChoicesInMedicare.com or visit our website:  www.ChoicesInMedicare.com

Medicare Eligible Women and Atrial Fibrillation Danger

A recent study concludes that atrial fibrillation (a-fib) affects women more significantly than men.   A-fib is a common heart rythm problem but women are twice as likely to suffer a stroke and a high percentage will die from heart attack compared to men.  This affects all women, both young and older, Medicare eligible women.  Women should take a-fib seriously and have it monitored.

For more info on this topic, see article linked here:  http://consumer.healthday.com/women-s-health-information-34/misc-women-s-problem-news-707/common-irregular-heart-beat-may-pose-bigger-threat-to-women-than-men-707195.html

For more info on how Medicare policies address these kinds of conditions, contact me at David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com website.

CMS Announces 2016 Changes to Medicare Part B Premium/Deductible

I reported this past July that CMS (who manages Medicare) announced there were possible, significant increases coming to Medicare recipients for their Part B premium and deductible.  This past Wednesday, Nov 11th, they announced that they have finalized the amounts of the increases.

The good news is they significantly scaled back the amounts of the increases.  2016 Part B premiums will increase from $104.90 to $121.80 for many people.  It will include those that newly enroll in Part B, those that don’t currently collect Social Security and higher income recipients primarily.  This increase will not affect approximately 70% of recipients that are currently on Part B and have the premium deducted from their Social Security check.

Part B deductibles will increase from current $147 to $166.  After several years of no increases, this will be much more tolerable than the initial amount proposed.

To read more about it, you can go to the CMS website linked here:  https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-11-10.html

If you have any questions about Medicare insurance coverages, feel free to email David@ChoicesInMedicare.com or go to www.ChoicesInMedicare.com.

2016 Medicare AEP Opens Oct. 15th Through Dec. 7th

It’s that time of year again for Medicare beneficiaries.  The 2016 AEP, or Annual Election Period, is the one time per year when Medicare beneficiaries can change their Medicare Advantage Plan or Part D drug plan without needing a special election period.  People who have a Medicare Supplement policy do not have to do anything with their policy unless they want to change their prescription plan.  The AEP begins Oct. 15th and runs through Dec. 7th.

Keep in mind this is also the only time the insurance companies can make changes to their plans.  If they do, they will send the member an Annual Notice of Change (ANOC) describing the changes for the upcoming year to be effective on January 1st.

If beneficiaries have questions or want to make changes, they should contact their insurance carrier or agent.

Or, they can contact David Higgs of Choices In Medicare at David@ChoicesInMedicare.com with questions.

Advantages of an Independent Medicare Insurance Agent

Again, I have completed all of my re-certifications for the upcoming AEP to continue being eligible to offer all of the Medicare Insurance plan types in Virginia.  This includes Medicare Supplement plans (Medigap), Part C Medicare Advantage Plans and Part D drug plans.  I have the re-certifications for all of the available Medicare Advantage plans and most Part D drug plans for the Central Virginia area as well as 7 of the most well-known Medicare Supplement plans.

It occurred to me what an advantage this is for clients and prospective clients who contact me with questions about enrolling in Medicare.  As an independent agent, I don’t work for any of the insurance companies, but am licensed, appointed and certified to represent the major Medicare insurers.  This means I can help people navigate through the many options available to them.  I become a one-stop resource instead of them having to contact multiple insurance companies one by one.  Without any bias towards any particular insurance company or type of plan, I help people find the best fit for them based upon their particular circumstances.  And, I don’t cost my clients anything.  You can imagine what they would get if they contacted an insurance company direct.

If you have questions about Medicare, contact David Higgs at David@ChoicesInMedicare.com or go to website: www.ChoicesInMedicare.com.