Tag Archives: medicare supplements

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 Beneficiaries’ Cognitive Health Tied to Heart Health

Here is another reason Medicare Beneficiaries should strive for improved Heat Health:  improved cognitive health.  A recent study released in the Journal of the American Heart Association found that the more heart-healthy steps people attain, the quicker and sharper their thinking skills.  So, not only will efforts to improve heart health help you live longer, but will help your memory and thinking skills.

To see more of the article, click on the following link:  http://consumer.healthday.com/cardiovascular-health-information-20/heart-attack-management-and-prevention-news-365/a-healthy-heart-may-protect-an-aging-brain-709040.html

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

Happy New Year! – New Medicare #’s to Know in 2016

It is New Year’s Day in 2016 and that means new Medicare numbers to know for this year.  In most years, CMS, who manages Medicare, increases some of the costs associated with Medicare Part A, Part B and Part D coverages.  The following shows some of the key numbers that have increased for 2016.

  • Part A deductible – Will be $1288 from $1260 (per 60 day Benefit Stay)
  • Part B Deductible – Will be $166 from $147 (Annual deductible)
  • Part B Premium – Will be $121.80 from $104.90 (Will not apply to existing 2015 beneficiaries who have it taken out of Social Security)
  • Part D Maximum Deductible – Will be $360 from $320 (Some plans don’t have a deductible)
  • Part D Premium National Average – Will be $34.10 from $33.13 (Is used to determine Part D Penalty)

While none of these are dramatic, it is still important to be aware of the changes.  Also, even with these increases, Medicare coverage and any applicable Supplemental coverages you may have is great coverage.

You can read more about this topic at Medicare.gov website by clicking on the following link:  https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-11-10.html

If you have questions about your Choices in Medicare, please contact me at 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.

Medicare and HSA’s Don’t Mix

I recently have had several clients who had questions about their options regarding Medicare and how it affects their HSA.  An HSA (Health Savings Account) is a tax advantaged account designed to pay for qualified medical expenses.  Medicare rules state that contributions cannot be made to an HSA if someone has Medicare, either Part A or Part B.  Medicare rules also state that Medicare is considered primary coverage for employees who are on an employer health plan that work for a company with less than 20 employees.  These rules can all intersect for some people.

So, a couple of scenarios arise for people who have an HSA:

1. If they work for a company with less than 20 employees and are on the employer health plan, they should enroll in Part B to have primary coverage.  But, if they are on a qualified High Deductible health plan with an HSA, they can’t have Part A or Part B in effect.  So, these people will generally be best served by leaving the employer HSA plan and go to Medicare.

2. If they work for a company with 20 or more employees, they do not need to enroll in Part B because their commercial insurance carrier for their employer health plan is considered primary coverage.  Someone becoming eligible for Medicare, can delay Part A and B to remain on the employer HSA plan.  They will need to make sure that Medicare does not automatically enroll them in Part A.

If you have an HSA and accompanying qualified High Deductible health plan, think about your options as you approach Medicare eligibility.  If you have questions, you can contact David Higgs at David@ChoicesInMedicare.com or visit www.ChoicesInMedicare.com

Possible Increase in Medicare Part B Premium Costs

Medicare will be 50 years old this month and Medicare’s Board of Trustees released a report this week that among other things, indicated a possible significant increase in Medicare Part B Premiums beginning next year.  While this increase would potentially affect only about 30% of beneficiaries, it could be significant.  Part B premium increases are common but usually small.  The potential increase would primarily affect new beneficiaries and higher income beneficiaries.  The head of Medicare will make a final decision this October.  The report also reported that the Hospital fund is expected to be solvent until about 2030.  You can read more about the report in the article linked below.

If you have questions about Medicare, contact David Higgs of Choices In Medicare at www.ChoicesInMedicare.com.

http://khn.org/news/good-news-bad-news-in-medicare-trustees-report/