Rescue Medicare Now – Help Stop Changes to Medicare and Medigap Plans

Dear Valued Clients and Seasoned Citizens:

I wanted to let you know that I’ve joined an organization that is very involved in getting the word out about various policy changes to Medicare that are being discussed as part of budget talks.

These are going to come up again in 2014, and I think it’s imperative that we all assist in making people aware of the possibilities and implications. These changes have been discussed (and proposed in the past) by Congressional members and leaders on both sides of the aisle. You can choose to get involved by contacting your Congressional representative.

I’ve inserted a video below. If you can, do watch it – it is 7 minutes long, but it does talk about some of the ideas that have been discussed and their possible implications. Most of them are directed at consumers “over utilizing” services because they “have good insurance”. This is not actually based in fact and has been disproven by several independent reports over the last few years. In reality, Medigap (Medicare Supplement) plans don’t drive “over utilization” since they do not pay until Medicare approves a service. In other words, Medicare dictates whether it is “medically necessary” and whether the Medigap plan will pay.

This video gives a good overview of what may be proposed – it’s been talked about in previous years with little traction, but many think there will be a greater “push” for changes this year. This would fundamentally change Medicare and Medigap plans.

If you are interested in doing something to make your thoughts known, one thing you can do is sign the petition at: http://rescuemedicarenow.com/petition.

Also, I would suggest that you can call your Congressional representatives as well. See: http://www.ahipcoverage.com/contact-congress/

I am sending this message to all my clients – not as a way to generate fear or false concern – but simply to make you aware of something that has been discussed and may be a part of upcoming budget talks. Feel free to share this information with friends or families – the more we can get this in the “open” the better. Regardless of what happens, if anything, I think we can all agree that the discussions and decisions need to involve the stakeholders who have a vested interest in Medicare and Medigap insurance – you, me and the millions of other seasoned citizens that rely on this valuable coverage.

Thank you for taking the time to read this and please do not hesitate to contact me at any time that you have questions. Email me here.

The Partnership to Protect Medigap – Help Preserve Medigap Plans

Medigap plans protect you against financial catastrophe – why not take some small actions to help protect Medigap plans, with the goal being to preserve Medigap plans’ existence in current form for yourselves and future Medicare-eligible individuals. There has been discussion off and on over the last 2-3 years about reforming Medigap plans. These discussions have ranged from eliminating first-dollar coverage (i.e. Plan F) to overhauling the plans completely to creating a Medicare deductible that cannot be insured against. While none of these plans became a part of PPACA (“Obamacare”) and none have been enacted, it is still important to be apprised of the fact that they have been discussed and likely will be discussed again soon.

Visit the PPM (Partnership to Protect Medigap) web site.

Visit the PPM (Partnership to Protect Medigap) web site.

First of all, to reiterate, nothing HAS changed with Medigap plans and the way they work as a result of PPACA

(“Obamacare”). On the contrary, Medicare Advantage plans were affected considerably, with reductions in funding and new regulations/restrictions. For Medigap plans, there were discussions that included changes to these plans, specifically the Kerry-Stark bill which would have forced Medigap plans to abide by the Medical Loss Ratios that the PPACA included for “under 65” plans. This would have made it difficult for most Medigap companies to compete and, most analysts agree, would have had a detrimental effect on Medigap rates. This and other ideas got pushed to the “backburner” during the PPACA talks and health care reform went forward without including them.

Now, however, is not the time for people who care about having the ability to purchase Medigap plans to fall silent and relax. The Partnership to Protect Medigap is one organization that is non-partisan and works to protect the Medigap plans that so many rely on. You can find out more here: Partnership to Protect Medigap. On their site, you can find out more about protecting Medigap plans and their viability into the future, as well as get information on contacting your Congressional representative and other ways to be involved in these efforts.

Medigap plans provide many benefits for those on Medicare, supplementing Medicare’s sometimes-insufficient coverage and “capping” (or eliminating, in the cases of Plan F) the total out-of-pocket expenses someone would have, regardless of the amount of care needed. Additionally, they provide the security of automated billing (i.e. no paperwork) and flexibility (can go to any doctor that takes Medicare). An independent American Viewpoint independent study found that over 90% of seniors were satisfied with their Medigap coverage. This is one of, if not the, highest among various insurance niches. For these reasons and more, those who have vested interest in Medigap should make the minimal efforts required to protect the future viability of these plans.

If you have questions about this or want to discuss in more detail, contact me online or call 877.506.3378.

Three Reasons the Name of Your Medigap Company Is Not Important

One of the most common thoughts, and understandably so, for many people “shopping” seniors looking at computer
for a Medigap plan is what company or companies have I heard the most about. This leads to people looking, primarily, at the companies that do the most marketing or the company that a neighbor or family member has. While this can lead to some good results – personal testimonials are often a great predictor of future performance – it can also lead to some “tunnel vision” and a lack of understanding of how the plans actually work and what factors should truly go into your decision-making process.

Put simply, the name of your company – even the rating of the company – is not ultimately very important when it comes to choosing a Medigap policy. This does not hold true with other types of insurance, where there are more variables and less standardization. But for Medigap insurance, the name of the company is virtually irrelevant. Here is why:

  1. First of all, the plans are Federally-standardized. This means that the coverage with one company is the same as the coverage with another company. For example, a Plan F with one company is the same as a Plan F with another. This means that price is, or should be, the primary differentiating comparison factor.
  2. Claim payments are paid through the Medicare “crossover” system. This is the same system used by all Medigap companies – it links your “original” Medicare Parts A and B up with your Medigap and insures that claims are paid on the same time schedule and in the same amount regardless of who your Medigap company is.
  3. You can use any doctor or hospital that takes Medicare regardless of which company you have. Different plans are not more or less widely accepted. As long as your doctor takes Medicare, he/she is required to take any of the standardized Medigap plans. Note that doctors offices, and particularly those that work in the insurance/billing offices, are not always well-versed on the different types of plans. And, some companies offer both Medigap and Medicare replacement plans like Medicare Advantage. Very often, someone in the billing department will say that they do not “accept” a certain Medigap plan, when in reality, they don’t have a choice as all claims are paid through the Medicare “crossover” (see point #2 above) and they are not filing specifically to the individual companies anyway.

It is important not to make a decision on a Medigap plan simply because you’ve heard the plan pays well or someone else is “happy with it”. Frankly, everyone is (or atleast should be) happy with their Medigap plan’s claim-paying performance because it is the very same from company to company. It is prudent to have an understanding of the above three points and compare Medigap plans on what really matters – price – before selecting a plan based on imagined or superficial differences. Otherwise, you could, like many others, end up paying “extra” every month for the exact same products that works the exact same way.

If you have questions about this or want to further discuss, you can contact me online or call 877.506.3378.

How Are Medigap Plans Affected by Obamacare?

healthcare.gov websiteThis is one of the most frequently asked questions that we receive from clients and people that we talk to on a daily basis about Medicare and Medigap insurance. So, how are Medigap plans affected by “Obamacare”?

The answer is a short and easy one – simply, they are not directly affected, or impacted, by the PPACA, or “Obamacare”, legislation, due to the fact that the plans are supplemental in nature and not “full-blown” medical plans. As such, Medigap plans are not subject to the requirements and restrictions on individual plans for people under age 65.

For people that have a Medigap plan, Medicare is, of course, still the primary coverage. Medicare covers, in general, 80% of the total, overall medical costs after doctor’s office (Part B) and hospital (Part A) deductibles. The Medigap plans step in to pay the Medicare deductibles (in most cases, depending on which Medigap plan you have) and the 20% after Medicare pays. The way this works – and the type of coverage that Medigap plans provide – has not been changed or impacted by the passage of the “Obamacare” legislation.

On the contrary, Medigap plans have historically been one of the more stable types of insurance since they became standardized in 1992. The actual plan designs have changed a couple of times since then, the last change occurring June 1, 2010; however, the way that the plan works and the overall outline of what they do has not changed.

Additionally, because of the standardization of plans (i.e. one company offers the same coverage plans as another, although rates may differ), the plans are relatively easy to understand, not nearly as complex as “under-65” individual insurance plans, and can be easily compared to one another.

Overall, many analysts project that “Obamacare” will cause some strain on the financial health of insurance companies that have elected to continue to offer individual plans. Learn more about Kratom which can help you to Increase focus and give you many benefits. This may cause some trickle-down to the portions of those companies that do Medigap insurance. However, this is uncertain at best, and for now, Medigap plans look like a safe bet to remain the same post-“Obamacare” as they were before the law was enacted.

If you have any questions about this or would like to compare Medigap plans for your area, please call us at 877.506.3378 or visit our website at http://medicare-supplement.us.

Medicare Annual Election Period Ends – Medigap Enrollment Still Open

The Medicare annual election period ended December 7. This is the time of year that you can change Medicare Part D plans or Medicare Advantage plans, if you are on one of those plans in place of traditional Medicare.Although the AEP is over, you can still make any changes you want to make to your Medigap coverage. Medigap plans do not have an annual enrollment period – you can change plans at any time for any reason, contrary to popular misconception.

If you are on a Medicare Advantage plan, you are locked in to that plan for the year now, unless you disenroll during the short Medicare Advantage Disenrollment Period (MADP), which runs January 1 through February 14. If you do choose to disenroll from your Medicare Advantage plan during this period, you can do so and return to “regular” Medicare A & B and pick up a Medigap plan to fill in the ‘gaps’ in Medicare.

For those on Medigap plans already, it is advisable to compare your Medigap plan to other options on an annual or bi-annual basis. With Medigap plans, rates change annually in many cases. While coverage does not change from year to year, it can make sense to “shop” your rate to make sure you are still getting a good deal.

Fortunately, this is very easy to do when it comes to Medigap plans, as the plans are Federally-standardized. In other words, if you have a Plan F now, you can “shop” other Plan F’s on the basis of rate, with the security that the coverage itself is going to be the same. Additionally, the plans all work in the same way – i.e. you can use them anywhere that takes Medicare, and claims are processed automatically through the Medicare “crossover” system.

If you have not compared your Medigap rates against other options in the last year or more, it is advisable to do so now. Also, if you have a Plan F, now is the time to consider Plan G. Plan G is a better “deal” in almost all cases and will provide annual savings and more rate stability.

If you have questions or want to compare your current rate against what is available, you can request a comparison on our Medicare-Supplement.US website or call us at 877.506.3378.

Switching Medicare Supplements – Can You Do It Mid-Year and Other Important Facts

Switching Medicare Supplement plans can be a good idea. Just like any type of insurance, rates are going to go up over time, and if you have had your Medicare Supplement plan for more than a year or two, chances are good that you can switch to another company and reduce your costs for equal coverage. So, what do you need to know about switching plans?

  1. First and foremost, know that you can switch plans mid-year, or any time really. There are no enrollment periods for Medicare Supplement plans – also called Medigap. This is not to be confused with Medicare Advantage plans, which are privatized plans that take the place of Medicare, or Medicare Part D, which is the Rx coverage that goes with Medicare. On Medicare Supplements, you can change plans at any time and it is very easy to do, particularly if you are in relatively good health.
  2. When you change plans, know that the coverage is standardized. All companies go by the standardized plans chart – Medigap chart. So, a Plan F with one company is the same as a Plan F with another. This makes comparing options easy to do – it is function of price and company rating/reputation.
  3. Whenever possible, use an independent agency to make your comparisons and provide you with additional information that you cannot get from the companies themselves. An independent agency has no significant incentive to “push” you go to with one company over another. You can compare plans in an unbiased way and get additional information, such as a long-term stability, company ratings, underwriting specifics, etc. So, whether it is us (Medicare-Supplement.us) or someone else, using an independent agency is always a good idea.
  4. Make sure you do not cancel your current plan until your new one is approved. Sure, this is pretty much common sense, but we see it done incorrectly every day. Here is the process for changing Medicare Supplement plans:
    • Compare plans
    • Choose a plan
    • Apply for the new plan with a future effective date (usually a month or so in advance)
    • Once the new plan is approved, cancel the “old” plan, effective that same future date

    This ensures that there is no gap or overlap in coverage.

Overall, changing Medicare Supplement plans can seem intimidating or overwhelming to many. This is what causes many people to stay on their overpriced plans and pay the “extra” amount those plans charge for the same coverage. In reality, it is advisable to compare plans on an annual or bi-annual basis, and if a savings is found, to easily make one and keep your medical costs as low as possible while maintaining the same level of coverage.

Garrett Ball is the Owner and President of Secure Medicare Solutions, Inc., which administers Medicare-Supplement.US. SMS is a leading, independent Medicare insurance brokerage, specializing in Medicare Supplement insurance. For more information or to get a Medigap comparison, you can visit us online.

Medigap Market Climate Report – June 2013

The Medigap market certainly changes from time to time. Although the plans are Federally-standardized, and all companies are required to offer coverage from the standardized plans (Medigap plans chart), there are many variables that do change from time to time. Some of these include the companies offering the plans in a certain area, the rates on the plans, the underwriting that the plans require and more. With that in mind, here is the Medigap market report for June 2013.

AHIP Report

First and foremost, AHIP (America’s Health Insurance Plans) put out a report recently entitled “Trends in Medigap Coverage and Enrollment, 2012”. This report details the landscape for Medigap plans as of December 2012. This report is very useful for both consumers and agents, in seeing the latest trends for Medigap policyholders.

Some notable takeaways from the report are:

  • There are 10.2 million Medigap policyholders, an increase of 300,000 over 2011 figures.
  • Plan F has the overwhelming market share among the standardized plans at 53%. Plan C is next at 13%.
  • 7% of people that have a Medigap plan still have Plan J (no longer offered and a “closed” block of business).
  • Plans M and N were the fastest growing plans from 2011 to 2012, growing at 808% and 35%, respectively. NOTE: Plan M only had 596 policyholders nationwide in the 2011 study.

The report also breaks down plan types and coverage by state. See the report in it’s entirety – AHIP Medigap Report.

Update on Medigap Reforms

One of the oft-talked about points related to Medicare reform is changing the way Medigap plans work. The most commonly discussed reform that pertains to Medigap directly is the elimination of “first dollar” coverage. This has been “on the table” for several years now with little movement; however, it’s possible it would be revisited and included in some type of comprehensive reform package.

To elaborate on what this means, “first dollar coverage” means that you pay a premium and no out of pocket costs (i.e. Plan F), which as we know from the AHIP report above, is a very popular route for those on Medicare.

Other reports and research have shown that eliminating this first-dollar coverage would have little to no impact on Medicare’s overall bottom-line.

Medigap Surcharges

Another aspect of Medicare reform that has been discussed is Medigap surcharges. This is also related to eliminating “first dollar coverage” as some are advocating applying surcharges on the higher-level plans such as Plan F. This would effectively eliminate those plans or greatly reduce their appeal and entice people to take plans that had more cost-sharing measures.

Obviously, this is a political “hornet’s nest”, and for that reason, many don’t believe it will happen any time soon (me included). But, it is certainly something worth keeping our eyes on (which I will definitely do!).

Regardless of what happens, the hope would be that anyone in a plan now would be able to keep the plan that they have if they would like to do so.

Hot Plans and Companies

While the Medigap market can sometimes be cyclical, there are some big names still at the “top” of the list when it comes to price competitiveness nationwide. In particular, when surveying overall rate competitiveness nationally, companies that continue to appear include:

  • Aetna
  • AFLAC
  • Central States Indemnity (a Berkshire Hathaway company)
  • CIGNA
  • Mutual of Omaha
  • New Era (and sister company Philadelphia American)

While the exact rates depend on your zip code, these companies are all highly rated and, on balance, have good overall track records.

As far as specific plans, Plan G continues to be a “hot” plan with many consumers now taking a more thorough look at ‘G’ for the premium savings and greater chance of long-term rate stability. Over 50% of our new policies in 2013 have been Plan G, and I would anticipate that to continue.

If you have any questions about this information or want to discuss in more detail, please contact me at 877.506.3378 or online at Medicare-Supplement.US.

Going on Medicare Part 1 – Understanding Medicare Parts vs. Medigap Plans

**This is Part 1 of a 5-part series intended to explain various aspects of Medicare and Medigap policies to someone turning 65 or about to go on Medicare.**You will, no doubt, be inundated with information by mail, phone and email regarding your upcoming transition to Medicare. This article explains the differences in “parts” and “plans”, which is a commonly confused difference that can lead to tremendous misunderstandings and mistakes when looking at plan options.

Part 1 – Parts vs. Plans – Lots of Letters and

Terminology!

One of the most confusing (to most people) things about turning-65 is understanding the terminology. More specifically, there are “parts” (of Medicare) and “plans” (Medigap). Many people get these confused and it can lead to making decisions that are not to your advantage.

Parts of Medicare

There are four parts of Medicare. Medicare Part A is the part that covers hospital and inpatient services. You get this automatically from paying into the Medicare system during your working life.

Medicare Part B is the part of Medicare that covers doctor’s office and outpatient services (like labwork, etc.). You must sign up for Part B in order to have this part of Medicare. There is a $104.90/month premium for this that is generally paid through a Social Security deduction.

Medicare Part C is an optional part of Medicare that is also known as Medicare Advantage. If you wish to stay with “original” Medicare (Medicare Parts A & B), you do NOT need to sign up for Part C. In fact, if you sign up for ‘C’, all of your coverage is provided through the private Part C company and Parts A & B no longer provide your benefits.

Medicare Part D is the prescription drugs part of Medicare. This part of Medicare is also optional and provided through private companies. In order to have prescription drug coverage, you must sign up for Part D. You can do this by calling 1-800-MEDICARE or through an independent agent.

Plans – Medigap

Medigap plans are also named by letters, which is the source of most people’s confusion. The plans are standardized and each company is required to offer the plans from the standardized plans chart. This chart goes from “A” to “N”. You should select a plan that meets your needs from a reputable company with low rates. You can view the full chart here that shows what the standardized plans cover: Standardized Plans Chart

If you have any specific questions, or if we can help in any way, please do not hesitate to reply to this email or contact us toll-free at 877.506.3378. We are a leading, independent Medicare Insurance agency. Because we are an independent agency, we work as a centralized place to compare all plan options, ask questions, and make unbiased decisions.

See Medicare-Supplement.US Testimonials

If you prefer to speak with someone by phone, please call me directly using the information below:

J. Garrett Ball, President
Secure Medicare Solutions, Inc.
Toll-Free: 877.506.3378

2014 Medigap Plans and 2014 Medigap Rates

It is essential to understand that Medigap plans and rates are not mandated to go by the calendar year. That said, many of the companies do choose to change their rates along with the calendar year. Plan coverage, however, does not change – once you are in a plan, you are in that plan unless you opt to cancel it or do not pay the premium.

While the rate changes that may occur on 1/1/2014 have not been announced yet, it is not too early to get ready to compare plans. In fact, it is not too early to even compare the plans if you would like to do so. Since there is no annual enrollment period for Medigap plans, you can compare plans at any time and, if a savings is found, you can change plans for equal coverage and a lower premium.

Most companies do increase rates over time – annually in many cases – and when the rates do go up, it is generally advantageous to compare other options to see if there is a savings to be found.

Over the last 3-5 years, there has been a definite upward trend in rates for Medigap plans, on average, nationwide. However, rates have, on the whole, stabilized somewhat in the last 12 months, as many new companies (or new to the Medigap space) have released plans. This has caused mean rates, in many cases, to actually go down. It is too early to tell what rates will do moving into 2014, but with the onset of the ACA (“Obamacare”), I think it is reasonable to assume that overall health insurance premiums will go up. Although the ACA does not pertain specifically to Medicare products, I believe there will continue to be some effect on Medigap rates.

Another variable that could impact Medigap plans and rates for 2014 is the passage of legislation regarding what plans can be offered. There has been, over the past few years, much talk surrounding the 10 standardized plans and revamping those plans. There have been some changes made already – i.e. the elimination of Plan J, adding Plans M and N – but a common belief is that there will be additional limits on first-dollar coverage at some point in the future.

2014 Medigap plans and rates are still up in the air right now. Although we cannot, in May 2013, foresee exactly what the rates will look like on 1/1/14, we can say without certainty that Medigap plans are now, and by all accounts, will continue to be a vital part of a sound financial plan for those on Medicare. If you have questions about this information or anything else related to Medicare or Medigap plans, you can contact us at Medicare Supplement agency or 877.506.3378. Also, please check back to our website, as we will have more information about changes to Medigap plans or new plans or rates as this information becomes available.