Annual Enrollment Period

The Annual Enrollment Period is quickly approaching! Do you need help with your Prescription Drug Plan?

The Annual Enrollment Period:

Mid October through the first part of December is often referred to as “Open Enrollment Period” or “Annual Enrollment Period”. They go hand in hand, and here’s why.  During this time, you can not only make changes to your stand-alone drug plan, but you can also make changes to your Medicare Advantage plan (depending on which one you have).  We recommend having someone like us in your corner to assist you through these changes.  Our only requirement for this annual assistance is that you sign up with a Medicare Supplement or Medicare Advantage plan through our advisors.  If you do not currently have one of those plans through us, give us a call today and one of our advisors will be glad to help.  They can be reached at (877) 759-5760, option 1.    

The Annual Enrollment Period comes every year at the same time, beginning October 15th and ending December 7th.  Some clients are under the impression that the Annual Enrollment period is the only time you can change or get a Medicare Supplement.  This is not true. The good thing about Medicare Supplements is that you can change them anytime throughout the year.  This Annual Enrollment Period is only for making changes in a stand-alone prescription drug plan or a Medicare Advantage plan.

Part D Late Enrollment Penalty:

One very important thing to remember is, if you do not obtain a drug plan when you are first eligible, you could receive a late enrollment penalty which is assessed by the Centers for Medicare & Medicaid Services (CMS). The penalty is 1% for each month you go without drug coverage and will always be added to any drug plan or Medicare Advantage plan when you enroll. If you have employer coverage and are on Medicare, I encourage you to check with your employer’s human resource department to ensure the coverage that you have is considered creditable drug coverage.

How can our services benefit you?

The drug plans change every year, so you will need to review your plan annually to see what changes are approaching.  That’s where MWG Senior Services can help!  We offer a FREE service to all our Medicare Supplement and Medicare Advantage clients each year by helping to review your drug coverage to see what changes are being made for the upcoming year. The drug plans are so highly regulated and have so much information to take in, it is hard to know which way to go. We do all the work for you! Already have a supplement with someone else?  No problem!  Any of our advisors can help you look at supplemental options that could help you save some money!

Have questions or need help with your Medicare supplemental options Call MWG Senior Services at 877-759-5760 or email us at seniorservices@morganwhite.com.

Medicare Covered Vaccination

With flu season right around the corner, let’s think of the best ways to protect ourselves from illnesses such as the flu and pneumonia.  Did you know that Medicare Part B (Medical Insurance) typically covers one flu shot per flu season and the pneumonia vaccination?  Also, there are other vaccinations that you could get free of charge, like the Hepatitis B, Shingles, and the Tdap Vaccinations.

Flu Vaccination:

In recent studies, between 71 – 85% of deaths associated with the flu have occurred in people over the age of 65.  This goes to show that the flu is a huge threat for people 65 and older, but getting vaccinated can help drop the risk of contracting the flu and maybe even save your life.  It is better to get the flu shot as soon as possible.  Early fall is best because it can take about two weeks for the antibodies to develop in the body and provide protection against the flu.

Medicare Part B covers the flu vaccination, but always check with your doctor to make sure they accept the assignment. 

Pneumonia Vaccination: 

According to the CDC, adults 65 years and older are at the greatest risk of serious pneumococcal infections that could possibly lead to death.  There are two different pneumonia shots available in the United States which can protect you and your loved ones:  Pneumococcal Conjugate Vaccine (PCV13 or Prevnar 13) and Pneumococcal polysaccharide (PPSV23 or Pneumovax 23).  The good news is that both pneumococcal vaccines are covered by your Medicare Part B when they are administered at least 12 months apart.  Make sure to check with your doctor to see if they accept the assignment before you decide where to receive the vaccinations. 

Hepatitis B Vaccination: 

If you are suffering from a condition that has lowered your resistance to infection and you are at high or medium risk for contracting Hepatitis B, Medicare Part B will cover this vaccination.  Check with your doctor to see if you are eligible and ask them if they accept the assignment.  If they do, it is in your best interested to take advantage and get vaccinated right away. 

Shingles Vaccination: 

Even though Medicare Part A and Part B does NOT cover the shingles vaccination, it might be covered by your Medicare prescription drug plan (Part D).  Check with your Medicare prescription drug plan carrier to see if it is covered.  Getting vaccinated from shingles could protect you from months and maybe even years of pain and suffering. 

Tdap Vaccination:

Tdap stands for Tetanus, Diphtheria, and Pertussis (whooping cough).  This vaccination isn’t covered by Medicare Part A or Part B, but your Medicare prescription drug plan (Part D) may cover it.  The CDC recommends that individuals get the vaccination if they have close contact with babies younger than 12 months and/or after you have experienced a severe cut or burn. 

Protecting yourself from these serious and possibly life threatening diseases is always a plus! When taking steps to ensure you are a healthier you, I have a saying I like to use; “carpe diem”.  So today, make a positive step forward in protecting yourself from potential preventative illnesses and Seize the Day! 

I hope after reading the MWG Senior Services blog, you call your doctor right away to schedule your vaccinations or check with your local pharmacist to see if they can administer the immunizations.  For more Medicare tips and education please visit our blog again soon!  MWG Senior Services is here to help you navigate the Medicare maze!  Please give us a call at 877-759-5760 or feel free to email us at seniorservices@morganwhite.com. 

Carpe Diem! 

Helping Seniors Navigate the Medicare Maze!

More individuals than ever before are turning 65 and becoming eligible for Medicare.  By 2030, 80 million people in the United States will turn 65 years old.  If you are approaching 65, you are probably being inundated with calls and mail, which can make it difficult to figure out which path to take.  Finding an agent who can help you navigate the Medicare maze should be a priority. 

I am about to provide you with some valuable advice.  You may even want to save it for future reference.  

If you are coming off a group plan and transitioning to Original Medicare, there is a possibility you will be eligible for Guaranteed Issue Medicare Rights (Medigap protections).  If you would like more information, please click here.

Navigating the Medicare maze

Discussing Part A, B, C or D, Medigap, Medicare Supplements, initial enrollment period, or Original Medicare can be confusing.  At MWG Senior Services, helping seniors navigate the Medicare maze is our specialty.  So, let’s get started.

Original Medicare is health insurance coverage managed by the federal government.  The two main parts are Part A (Hospital Insurance) and Part B (Medical Insurance).  Part A covers care in a skilled nursing facility, inpatient hospital stays, hospice care, and some home health care.  A rather large number of US citizens will not be required to pay for their Part A monthly premium.

Premium-free qualifications for Part A at 65 years of age:

  1. If you or your spouse has worked 40 or more quarters paying Medicare taxes.
  2. If you receive retirement benefits from Social Security or the Railroad Retirement Board.
  3. If you are eligible to get Social Security or Railroad benefits, but haven’t filed for them yet.

If you OR your spouse had Medicare-covered government employment.

Premium-free qualifications for Part A if you are UNDER 65 years of age:

  1. If you received Social Security or Railroad Retirement Board disability benefits for 24 months.
  2. If you have End-Stage Renal Disease (ESRD) and meet certain requirements.

Part A Premiums

According to Medicare.gov, if you paid Medicare taxes for less than 30 quarters (7 ½ years), the standard Part A premium is $413 in 2017. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $227.  But in most cases, if you choose to buy Part A, you must also purchase Medicare Part B (Medicare Insurance).  You will be required to pay monthly premiums for both.

Part B Premiums

Historically, Part B premiums have increased every year.  In 2017, the Part B premium is $134 (or higher depending on your income).  If you are currently receiving Social Security benefits, you could have a decreased Part B premium. 

In Original Medicare, Part B will cover certain doctor services, outpatient care, medical supplies, and preventive services. 

Two types of services Part B can cover:

  1. Medically necessary:  Services or supplies needed to diagnose or treat your medical condition which meet accepted standards of medical practice.
  2. Preventive:  Services which provide healthcare to prevent illness (like the flu), or detect it at an early stage when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a healthcare provider who accepts assignment.

What Original Medicare (Part A & Part B) doesn’t cover

It’s no secret that Original Medicare doesn’t cover everything, nor does it pay in full.  You could be stuck paying out-of-pocket for the portion not covered by Medicare, unless you have other insurance (Medicare Supplement or Medigap policy), or you’re in a Medicare health plan (like Medicare Advantage Plans).  With Original Medicare, you could be responsible for your deductible, coinsurance, or copay.  Purchasing a Medicare supplement or Medigap policy can help pay some of the healthcare costs that Original Medicare doesn’t cover.

Also, when you purchase a Medicare Supplement, such as a Medigap policy, it could cover up to 20%.  This could help you have less out-of-pocket expenses when your personal health isn’t at its best.  For instance, a Plan F Medicare Supplement would insure maximum coverage. 

You can purchase a Medicare Supplement at any time during the year, unlike Medicare Advantage plans (Part C).  All Medicare Supplements are standardized, so a Plan F with one carrier has the same coverage as a Plan F with any other carrier. 

Plan G is also very popular because the only difference between a Plan F and a Plan G is the Medicare Part B deductible cost.  With Plan F, you pay nothing, but with Plan G, you pay a one-time cost of $183 (current cost as of 2017) for Part B services.  This deductible typically changes and starts over on January 1st of each year. 

These plans are considered portable because you can use your insurance in any state in the US, as long as the doctor accepts Medicare.  Medicare Supplements typically don’t cover long-term care, vision, dental, hearing aids, eyeglasses, private-duty nursing, or Prescription Drug Plans (Part D).  You can purchase these as stand-alone policies if it fits your needs.

To compare prices of different Medicare Supplement plans and carriers located in your area, click here.MWGSSMedicareMazeVideo2

 

Part D (Prescription Drug Plans)
Prescription Drug Plans are important and you will need to make sure the plan you choose is considered creditableprescriptiondrug coverage.  If you don’t have creditable prescription drug coverage, you could pay a late enrollment penalty.  This means, you will be required to pay a higher monthly premium and that penalty continues each year.   We suggest, if you are currently not taking any drugs, you will still need a low-cost premium plan to prevent having to pay high or late enrollment penalties later in life.   Medicare multiplies 1% of the national base beneficiary premium by the number of full, uncovered months you didn’t have Part D or creditable coverage.  That amount is added to every monthly premium for the remainder of the service. This can be an issue for those on a strict budget, therefore, we want to help prevent you from being penalized.

Medicare Advantage (Part C) plans administer Original Medicare (Part A & B).  Most Medicare Advantage plans offer prescription drug coverage.  With Part C plans, you must have a primary care physician and you may have to be referred before you can see a specialist.  You must also choose a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service Plan, Special Needs Plan, and Medicare Medical Savings Account Plan.  These plans are not typically considered portable because of the network stipulations and regulations.  

Initial Enrollment Period

If you are new to Medicare, turning 65, and ready to hop on the Medicare bandwagon, you can sign up for a Medicare Advantage or Part D (Prescription Drug Plan) during your Initial Enrollment Period.  Your Initial Enrollment Period begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.  

Open Enrollment Period

Medicare Supplement (Medigap policy) plans have a different time period that you can sign up with no health questions.  When you first enroll in Part B, you can enroll in a Medicare Supplement with no medical underwriting starting 6 months before your Part B effective date until 6 months after your Part B effective date.

There are definitely different ways you can obtain creditable coverage and navigate the Medicare maze.  Everyone’s situation is different and there isn’t one option made to fit all.  We advise you to look at a several different avenues to see which option best fits your needs. I hope the information you take from our blog will leave you more knowledgeable and happy!  Life is too short to worry about which road to take when navigating the Medicare maze.  Give us a call at (877) 759-5760 or send us an email at seniorservices@morganwhite.com.  Be sure to mention that you heard about us through our blog.  Have a great day!

Source:  Medicare.gov