Top Five Misconceptions about Medicare and Medigap

medicare mythsMedicare can be complex – there are “parts” and “plans”, changes and updates, ins and outs that only the most experienced or devoted person could follow and understand. Moreover, there is a great deal of misinformation out there about Medicare and Medicare supplement plans, particularly this time of year as we approach the end of year annual election period. As an independent Medicare insurance and Medigap agency, we hear these misconceptions over and over. It is an uphill battle to fight against the misinformation and misunderstandings regarding Medicare and Medigap plans. But in a small way, this article may help shed some light on the top five misconceptions about Medicare companies and the helping hand medicare you can get.

1. “When I turn 65, I’ll get Medicare for free.”
Unfortunately, this one is not true in most cases. There is a premium associated with Medicare Part B (currently $134/month) that is typically paid as a deduction from your social security check. If you are not receiving Social Security, you can also pay this quarterly by receiving a bill. This amount can be higher or lower based on your income. Find out how much you will pay for Medicare Part B.

2. “The end of year enrollment period applies to Medicare supplement, or Medigap, plans.”This misconception is very prevalent this time of year, as we approach October 15, which is the start of the annual election period. Many people mistakenly believe that this end-of-the-year period also applies to Medicare Supplement, or Medigap, plans. However, that is not the case. The end-of-the-year period only applies to Medicare Advantage and Part D plans. You can actually change Medigap plans at any time but do have to qualify medically (in most states) when you do so.

3. “Medicare Advantage plans are a type of Medicare supplement.”Medicare Advantage plans are completely independent of and different from Medicare supplement plans. On the contrary, they take the place of Medicare A & B, whereas supplement plans (also called Medigap) “supplement” Medicare. If you opt on to a Medicare Advantage plan, which is a privatized version of Medicare, instead of Medicare itself, you can go back to having Medicare during the annual election period, but to get a Medicare supplement, you generally would have to qualify medically. You can also get supplements as maeng da from independent suppliers and still get the advantage of Medicare.

4. “Medicare does not cover any preventive care.”This one was more true in the past than it is now. Medicare does now provide coverage for a good bit of preventive care (much of this is relatively new). Here is a breakdown we did previously of some of the more common preventive care that Medicare does cover. Most importantly, Medicare does cover a “welcome to Medicare” physical when you turn 65 and also an annual wellness check-up even if it is at specialized institute as Imagine Wellness Centre.

5. “I need to find out if my doctor takes this Medigap plan (or the related misconception of, “I am going to ask my doctor which Medigap plans pay him faster or more”)This misconception is easily understood, when you consider that it is rooted in (for most people) years of worrying if their insurance is paying their claims in full or quickly enough. However, these concerns do not carry over to “over-65” insurance, at least if you are talking about Medicare and a Medigap plan. For Medigap plan, claims are paid through the Medicare “crossover” system. And, they are paid in the same amount on the same time schedule, regardless of which company you have for your Medigap carrier. Additionally, Medigap plans do not have networks – if a doctor takes Medicare, they are required to take the standardized Medigap plans.

While there is a lot to decipher and understand related to Medicare and Medigap plans, it is crucial to your health and financial well-being to do so, it is important to know that there is also other solutions for any health problem such as hiring acupuncture Miami
where they offer a new way of giving your body good health. If you have any questions about this information or wish to further discuss Medicare and Medigap plans, you can contact us online or call us at 877.506.3378.

How to Make the Right Medigap Choice

logo-collage-smallChoosing the right Medigap plan can be a time-consuming and overwhelming process if you allow it to be. While there is a lot of information out there and a lot of people and companies vying for your “attention”, choosing a Medigap policy does not have to be difficult. Follow this three-step guide to narrowing the choices, reducing the clutter and selecting the plan that is right for you.

  1. Understand the plans. First of all, you must have an understanding of the plans – what they cover, how they work and what is important in the decision-making process. The first thing to know is that the plans are Federally-standardized. That is, all companies provide the same coverage plans – a Plan F with one company is the same as a Plan F with another company. Additionally, the plans all work the same way. Claims are automated (paid electronically without involvement from the patient), and they are done through the Medicare “crossover” system. Lastly, all plans can be used at any doctor or hospital that takes Medicare. In other words, as long as a physician takes your primary coverage (Medicare), they will take your Medigap plan regardless of what Medigap company sold you the plan.In summary, and the main thing to understand when it comes to Medigap plans, is that there are no differences to compare as far as coverage, reliability, how the plan works, where you can use it, etc. The two factors to compare when it comes to Medigap are price (first and foremost) and company rating/reputation. The Federal standardization of plans has made the other variables non-existent or irrelevant.
  2. Compare the rates. Once you understand “what” to compare, it is time to actual do the comparing. There are a couple of ways to do this. The “old-fashioned” way is to get the phone numbers of all companies offering Medigap plans in your area and call them and ask their rates. Some companies will give you this information over the phone; some will require that an agent come to your house to meet with you prior to giving you the information. For most people, this way of doing it is not appealing. However, it is an option.The other way of going about it – which I believe most people would find preferable – is to use an independent agent, or broker, to compare the plans. An independent agent does not work specifically for one particular insurance company, so they are not going to try to “sell” you on their company. Instead, they can give you unbiased information of what company’s offer competitively priced plans in your area. Additionally, they can provide other information such as company rating, past rate stability and reputations, which may help you narrow down the choices and make an informed decision.Keep in mind that the main thing to compare when it comes to Medigap (Medicare Supplement) plans is the rates, as plan coverage is completely standardized by the Federal government. A good independent agent can provide a full breakdown of the companies that offer companies in your zip code, as well as what the rates would be for someone at your age.
  3. Choose wisely. Once you have the information that pertains to premium rates and company rating/reputation, you can easily narrow the choices to which reputable companies are competitively priced for your area. While many people know about Plan F, which is the most common plan, it is not always the most wise choice. It is the most comprehensive but also the most expensive. Plan G is an alternative that typically would provide a savings when compared to Plan F – under Plan G, you have to pay a $147/year deductible but that’s the only difference between ‘F’ and ‘G’ and the premium savings is often $300+/year resulting in a significant net savings.Once you choose a plan, it is easy to enroll, particularly if you are in an “open enrollment” period (i.e. turning 65 or just going on Medicare). Simply complete an application, which the independent agent can facilitate either online or by phone, then the application will be processed by the insurance company. You’ll receive an insurance card and policy in the mail.

While signing up for a Medigap plan is an overwhelming charge for many people, it does not have to be. The standardization of Medigap plans and the proliferation of information available online has made comparing and choosing a Medigap plan much easier than choosing most other types of insurance.

If you would like a listing of the companies/rates in your area or have other questions, you can contact us online or call 877.506.3378.

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.

Supplemental Medicare Plans – What Are They and Who Needs Them?

Supplemental Medicare plans are plans that “follow” behind Medicare and fill in the gaps in coverage in Medicare. These plans are also called Medicare supplements or Medigap plans, and they are sold through private insurance companies. There are a handful of these options out there and they vary by state, so it is important to be apprised of what’s available in your area if you are trying to determine if this type of a plan is a good idea for you. Here are a few considerations:

  • First, you should understand what you have. Are you on an employer group plan now? If so, will that plan continue even after you go on Medicare? And, at what cost to you? If you do not have other coverage, such as a employer-based plan or retiree plan, will you plan to have only Medicare coverage?
  • Next, it is essential to understand what Medicare does and does not cover. Medicare is relatively comprehensive coverage; however, it does “leave out” an unlimited 20% of medical costs at the doctor/hospital. In other words, if you have only Medicare – with no supplemental Medicare plan – you would be responsible for an unlimited 20% of costs at the doctor/hospital.
  • Last, you should understand what a supplemental Medicare plan would do for you in order to decide if it would be a good idea. There are two types of plans available to those on Medicare – actual supplement plans and Medicare Advantage plans. It is important not to confuse the two. Medicare Advantage plans take the place of Medicare – they do not supplement it. The coverage is at a lower level, and although premiums are also lower, there are some things to consider such as network restrictions, future portability and long-term viability.

Your health is very important to your all-around well-being, particularly when you are of Medicare age. Because of that, it is wise to consider whether a supplemental Medicare plan makes sense for you. It can give you financial peace of mind as well as providing for good, long-term health.

 

Effects of “Obamacare” on Medicare & Medicare Supplements

“Obamacare”, or the PPACA, was signed into law in March 2010. Many of its provisions have been slowly becoming integrated into our health care system. And, in 2014, many of the individual health provisions take effect. For people on Medicare, many are wondering how “Obamacare” will affect them. As a Medicare Supplement brokerage, this is a question we receive almost daily.

If you have Medicare, regardless of what type of supplement coverage you also have (if any), you will be affected by the PPACA. First of all, there have been some relatively significant changes to how the “donut hole” is administered on Part D (Rx coverage). If you have not “felt” these changes yet, it is because they are being rolled out little-by-little over the next few years, culminating in 2020.

On Medicare itself, although there were many significant changes discussed, the coverage on Parts A and B (hospital and doctor’s office, respectively) were not overhauled or changed in prolific ways. Some things were changed, however. These include more preventive care being covered (i.e. wellness checks) and more protection against fraud and abuse of the system.

Now, as you no doubt know, this legislation did not come without a price tag. Some of the PPACA was paid for through reductions in funding to privatized Medicare plans called Medicare Advantage. These plans, although they still exist, may experience reduced funding and thereby not be able to deliver benefits that are as “rich” as they have been in the past.

For Medicare Supplement policyholders, the changes are non-existent to your current policy. Nothing changes about your plan or coverage. The PPACA did not even change the standardized plans chart, although this was a part of some of the discussions and may happen in the future. Medicare Supplements remain one of the few relatively stable things about the current state of affairs in our healthcare system.

If you have questions about this or how your coverage has been, or will be, affected, feel free to contact us online or call 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.

Secure Medicare Solutions June 2013 Agency News

Secure Medicare Solutions has had a great start to 2013 with many new, happy clients and lots of competitively priced plans. There have been several new companies to come into the Medigap marketplace, including CIGNA and AFLAC (two big names now offered in some states), which we’ve added to our portfolio. Also, we’ve been able to help many spouses of current clients move onto Medicare with ease and confidence.

Spouse Turning 65?

If your spouse is turning 65 soon, make sure you contact us 2-3 months in advance of their birthday. Some companies offer a husband-wife discount that would apply to your policy, as well as your spouse’s policy (assuming you are with the same company). This is certainly worth taking advantage of and can mean hundreds of dollars of savings in a year.

Term-Life-Comparison.com – A New Venture

Secure Medicare Solutions, Inc. has a new venture that we are working on – http://term-life-comparison.com. This site is designed to serve those looking for term life insurance quotes or information. It is a work in progress.

On the site, a consumer can compare term life insurance quotes all online without having to speak to, or meet with, an agent. And, if they so choose, they can even sign up for a plan online. If you are in the market for life insurance, visit the site and see what you think. You can compare multiple options in one place so you can choose the plan that is the most competitively priced for the option you are looking for.

If you have any questions or want to speak to us, give me a call at 877.506.3378 or email me.