When can I buy a Medigap policy?

Are you turning 65 soon?  You might find out that looking through Medicare options is like trying to put together a 1,000-piece jigsaw puzzle.  Fortunately, in this and upcoming blogs, we have selected some frequently asked questions to talk about in more detail.  

We hear this question all the time; “When can I buy a Medigap policy?”  The good news is you can buy Medigap (Medicare Supplement) at any time throughout the year and you don’t have to wait until October 15 – December 7.  The stipulation is, you might have to go through underwriting to qualify for a different Medigap policy. 

In this blog, we will outline:

(1) When you can purchase a Medigap policy without having to go through underwriting.

(2) What is underwriting?

(3) When you can change your Medigap policy if you aren’t happy with it. 

If you purchase your Medigap policy when you are first eligible for Medicare, you can purchase any policy sold in your state without having to go through underwriting.  This means if you have any health problems, you can purchase a Medigap policy at the same rate as a healthy person, if you purchase it within your open enrollment period.  Each person’s open enrollment period will start the first day their Medicare Part B is effective and it will last for 6 months. 

If you decide to change your Medigap policy outside of your open enrollment period, typically you will go through underwriting.  This means, if you have some health problems, the insurance companies could either deny coverage or charge you more due to certain health conditions.  Keep in mind, even though Medigap policies are standardized, the health questions are not.  So, just because you may not qualify for one carrier doesn’t mean that you will be turned down for another carrier.  Check with our advisors to see if there is an option that fits your needs. 

If you are about to lose your group health coverage, you might be eligible for Guaranteed Issue, which is another way you can purchase a Medigap policy without having to go through underwriting.  There are many different qualifications for a Guaranteed Issue period.  Please click here to learn more about your Medicare rights.

To compare prices of different Medigap policies and carriers available in your state, click here.

Now that you know you don’t have to wait until October 15 – December 7 to make changes to your Medigap policy, and you know a little more about changing your Medigap (Medicare Supplement), please don’t hesitate to give us a call at (877) 759-5760 or send us an email at seniorservices@morganwhite.com with any questions you may have pertaining to your specific situation.  Be sure to mention you heard about us through our blog!  Have a great day! 

Source:  Medicare.gov

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

Medicare Advantage Disenrollment Period

When can I disenroll from my Medicare Advantage plan?

Are you unhappy with your Medicare Advantage plan?  Did you know that the Medicare Advantage Disenrollment Period (MAPD) is January 1st – February 14th every year?  If you are unhappy with your plan, you can disenroll during this time and return to Original Medicare (you cannot switch to another Medicare Advantage plan at this time, but you can enroll in a Part D stand-alone drug plan).  If you miss this period, your next opportunity to change your plan is during the Annual Enrollment Period which is October 15th – December 7th of each year.

But before you disenroll, we recommend that you speak with someone to see if a Medicare Supplement is right for you.  Keep in mind that most people will have to answer health questions, but there are some that may qualify for a Guaranteed Issue period which would eliminate the underwriting process.

We want to help you make an informed decision!

If you would like additional information, please give us a call at 1-800-800-1397 ext. 1397 and mention that you read our article on the Medicare Insurance Finders blog.  We will take care of you just as we would our own family.  We look forward to speaking with you soon!

 

Compare Part D Plans

It is that time of the year – time to compare Part D plans.  It is the Annual Election Period next week and this is the time of the year which you can compare and switch Part D plans.  You do not have to compare or switch plans, but it is highly recommended since these plans will change each year.

What is the Annual Election Period?

This is a time which you can enroll, disenroll or change your Medicare Advantage Plan or Prescription Drug Plan.   This time frame also gets commonly called the Open Enrollment Period.

It is highly recommended to start your comparison on October 15th when it begins, waiting until December can put you at a risk of getting enrolled prior to the December 7th cut off date.

Do Part D Plans change each year?

Yes, Part D plans change every year that is why it is so important to compare your options.  An example that comes to mind is a company that had a great plan three years ago.  The premiums where less than $20 per month and there was no deductible.  Needless to say that plan did not stick around more than 1 year without doubling its premium and beginning to cover less drugs.

Compare Part D plans annually to make sure that your plan covers your prescriptions, has an affordable premium and to know that your pharmacy accepts that insurance company’s plan.

Compare Part D Plans

How do I compare Part D plans?  That is a great question and the easy answer is to say go to medicare.gov and compare the plans.  However, that is not an easy task for most people.  Usually you will want to make sure you have a senior market advisor to help inform you of the different “gotchas” to the plan.  An example of these could be step therapy, prior authorization, and quantity limits.

The company may cover your prescription but only cover it one per day when you need to take 2 per day.  This means that you will have to pay out of pocket for the remaining costs.  An annual review can help make sure you have a plan that suits your needs.

Call 1-877-936-2991 for help with your insurance needs.

Compare Part D Plans

Medicare Insurance Finders helping you with your 2014 Medicare Supplement insurance needs.

MA NEWS! 2014 Plan Design!

There was MA news released late yesterday afternoon!  Medicare Advantage plans after much push back from congress, Medicare Advantage enrollees  and insurance companies will not be receiving a cut in 2014.   The proposed 2.3% cut has now been removed and an increase was given to the Medicare plans run by private insurance companies. Continue reading

Medicare Plans in North Carolina

As you may already know Medicare plans vary in every state across the country. Medicare Plans in North Carolina have better priced options than most states with their Medicare Supplement plans starting around $100 a month.

Medicare Plans in North Carolina

  1. Medicare Supplement Policies or Medigap Plans provide supplemental coverage to Original Medicare.  These plans fill in the gaps (deductibles, copays, and coinsurance) that Medicare does not cover.  These plans are standardized which means every insurance company has to provide the exact same coverage (Plan F is the most popular plan).
  2. Medicare Part D Prescription Drug Plans provide help in covering your prescriptions.  These plans can vary greatly and are not standardized so make sure to compare formularies and limitations before enrolling in a plan.  A Senior Market Advisor at Medicare Insurance Finders can help assist you with this.
  3. Medicare Advantage Plans take over the administration of your Medicare benefits.  In other words, Medicare Advantage Plans will pay the providers their Medicare fees for service but under their negotiated agreements.  MA plans can sometimes include prescription drug coverage and at times can be $0 premium.  However, there are deductibles, coinsurance, co-pays and a common $5,000 + out of pocket maximum per year.

North CAROLINA MEDICARE SUPPLEMENT RATES

Medicare Insurance Finders specializes in Medicare Plans in North Carolina.  We provide the #1 Medicare Supplement Quote Engine in the market.  Our rates are updated monthly and provide the most competitive Medicare Supplement Plans all across the country.

As mentioned in most of our articles rates are the most important factor when it comes to Medicare Supplemental Insurance.  Below are the rates for Medicare Plans in North Carolina.

Medicare Plans in North Carolina

Medicare Supplement Insurance

How to Proceed

If you are wanting to move forward with advice or enrollment about our North Carolina Medicare Supplement Plans, please call us at 1-800-800-1397 option 6.  We will help guide you to the best Medicare Supplement Plan available for your needs.

Need Medicare Supplement Insurance

If you need Medicare Supplement Insurance and are looking for supplemental plans that fit your budget – LOOOK NO FURTHER.  Medicare Insurance Providers offers you online Medigap Quotes.  We do not sell your information so do not worry about filling out the lead form and having hundreds of agents call you.  Before you get a quote there are a few things you should know about Medigap or Medicare Supplement Insurance.

  1. The first thing to understand is that Medicare Advantage Plans are not the same as Medicare Supplement Plans.  Medicare Advantage Plans take over Original Medicare where Medicare Supplement Insurance fills in the gaps of Medicare.  Medigap plans do not include Part D coverage while a lot of Medicare Advantage Plans do contain prescription drug coverage.
  2. If you need Medicare Supplement Insurance you should compare rates before choosing a plan.  Websites like Medicare Insurance Finders allow you to see up to 25 insurance company’s rates so you can see who offers the best price.  Unlike many things in life price is the most important factor with Medigap plans.  Coverage is standardized so two companies offering Plan F insurance must provide the same basic coverage. (APPLES TO APPLES)
  3. Compare financial stability of the different companies.  As long as you choose a company with B+ or higher rating you should be just fine, but a lot of people like to choose an A rated carrier just to make them feel better – I completely understand.

Need Medicare Supplement Insurance

Most people need Medicare Supplement Insurance quotes and/or advice when one of the following situations takes place:

  • Losing Group Coverage
  • Turning 65
  • Medicare Supplement Rates on current policy increase
  • Losing Medicare Advantage Coverage
  • Moving to a different area
  • Unhappy with current coverage (usually due to price or provider restrictions)

If you are looking for help with your insurance coverage call our office (1-800-800-1397 option 6) for all the advice and guidance you need pertaining to Medicare Supplement Insurance.

Need Medicare Supplement Insurance

Providing advice on Medicare Supplements for individuals with health issues

Health Insurance Tax – 2014

Most everybody across the country knows that the Affordable Care Act (PPACA), commonly referred to as Obamacare was passed in 2010.  There was debate that went to the Supreme Court over whether the law was legal.  The Supreme Court ruled that the United States government is basically imposing a tax not a “penalty” so it was declared lawful. Many people referred to this as a health insurance tax and not a health insurance program.  It turns out that they may have been more accurate than we thought.

Starting in 2014, there will be a health insurance tax that is imposed on the fully insured market (Self-Funded Plans are Exempt).   Currently most groups are on a fully insured plan and probably 90% of companies across the United States with under 50 employees are self-insured.  Now that people have had time to read the bill, this health insurance tax will greatly hinder small business production.

2014 Health Insurance Tax

How much is this health insurance tax that takes place in 2014?

  • PPACA will assess each health insurance company based on their “net premiums written” to know how much the tax will be to each insurance company.
  • The insurance companies will pass this along to the business on a fully insured group plan or individual plan.
  • The average family should see an increase of roughly $500 a year.
  • The insurer fee in 2014 will be 8 billion dollars.
  • The health insurance tax increases to 14.3 billion in 2018
Health Insurance Tax

2014 Health Insurance Tax – Obamacare

Basically this law just created a lot of extra taxes on our health insurance that will ultimately make our premiums increases.  The loss ratios haven’t even started for these plans and we know just on this one portion that there is an extra 8 billion dollars in expenses.  Now throw in  No Insured Maximums, No Health Questions, and 1,400 pages of new laws to comply with and you get yourself a nice little rate increase.

What does this tax pay for and what products are affected?

This tax is built to pay for the subsidies of individuals between 100% and 400% of poverty level.  Which some people may benefit greatly from this tax because they will receive their insurance at a much lower premium.

Products affected by this tax will include group health plans, individual plans, Medicare Advantage Plans and supposedly Part D plans.  In the law Medicare Supplement Insurance is exempt from this tax.  Medigap plans are also not under the same guidelines of no health questions.

MWG SENIOR SERVICES – 800-800-1397 option 6

 

 

Medicare Advantage Cuts

We all heard during the elections how President Obama and Presidential hopeful Mitt Romney argued about the Medicare Advantage cuts from the Affordable Care Act.  Mitt Romney sited that there was over 700 billion in MA cuts, while President Obama argued that this was absurd.  Well the truth came out this week when Medicare Advantage cuts appeared larger than anticipated.

Medicare Advantage Cuts

The last week of February, the Centers for Medicare and Medicaid Services announced a further cut of 2.3% in Medicare Advantage Payments in 2014.  This sent the Medicare Advantage Plans into an uproar stating that they were already getting close to a 5% cuts to their plan and adding this 2.3% would put them right at 7% cut.

The insurance companies were not the only ones who noticed these cuts.  Companies that are publicly traded and offered MA Plans all took a hit.  Some companies like Humana and United Healthcare took large hits (roughly 8%).

Medicare Advantage Cuts

Medicare Advantage Plans verse Medicare Supplement Plans

What do these Medicare Advantage cuts mean?

To a consumer these Medicare Advantage cuts mean either a loss of benefits, higher premiums or both.  AHIP recently released a statement that members will probably get some unpleasant surprises in 2014 plan year.  Some of the possible changes could be premium increases from $50-$90 per month or cut in benefits.

If premiums increase and benefit are cut we are expecting Medicare Supplement plans to increase enrollments.  These plans supplement Original Medicare and pick up the deductibles, coinsurance, and co-pays that accompany covered Medicare services.  Medicare Supplements normally have higher premiums than Medicare Advantage Plans, but they do provide much more extensive coverage.

These Medigap plans also do not limit providers available, but MA plans do limit their members to specific networks which is the major issue with people who have enrolled in a MA Plan.  Basically these MA cuts will stir up some change in the Medicare market towards the end of 2013 (Annual Election Period) so people have a chance to change prior to the 2014 plan year.

 

Medigap Providers

When turning 65 and considering Medicare Supplemental Insurance one thing to consider would be “Is my doctor a Medigap Provider”. The term “Medigap Providers” is another way of referring to the doctors and hospitals that accept Medicare.  Any provider that accepts Medicare will accept a Medicare Supplement as well.  So basically what you should ask yourself is, “does my doctor accept Medicare”.

Medigap plans are different from Medicare Advantage Plans in many ways, but the biggest difference is the network of these two plans.  As mentioned above, Medigap providers are any physician that accepts Medicare.  However, Medicare Advantage Plans have specific networks that you are required to follow to receive benefits at discounted prices (HMO, PPO, PFFS – all vary slightly on network design). Continue reading