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.

Vaccinations that are Covered by Medicare

With flu season right around the corner, we should be thinking 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 vaccinated as soon as possible.  Early fall is best because it can take about two weeks after you have been vaccinated for the antibodies to develop in the body and provide protection against the flu.

The flu vaccination is covered by your Medicare Part B, 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 it is typically covered by your Medicare prescription drug plan (Part D).  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 threating diseases is always a plus! When it comes to 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! 

Top 10 Medicare Supplement Companies

Do you ever wonder which Medicare Supplements are available in your area and how they work? First, it is important to know, you must have Medicare Part A and Part B to receive a Medicare Supplement.  All Medicare supplements are standardized and any plan is guaranteed renewable, even if you have health issues. The carrier cannot cancel your plan as long as you are paying the monthly premium.  Although every carrier offers the same plans, the rates are different based on age, gender, tobacco usage, location and sometimes health conditions.

Each carrier does implement rate increases each year for every plan. You will receive a letter from the carrier annually, 30 days prior to let you know you are receiving an increase. The average annual rate increase is roughly between 6-10%.

Each carrier has several different plans, such as A, B, C, D, F, G, K, L, M, N.  All plans offer the same benefits, but in some cases, additional benefits are offered.  You have the flexibility to choose which plan best meets your needs. 

MWG Senior Services selects the Top 10 Medicare Supplement companies based on their rating and their annual historical rate increases.   

Top 10 Medicare Supplement Companies:

1.            American Continental
2.            American Retirement
3.            Philadelphia American
4.            New Era
5.            Combined
6.            Mutual of Omaha
7.            Central States
8.            Aetna
9.            Gerber life
10.         American National

 

MWG Senior Services represents all of the Top 10 Medicare Supplement companies listed above and more. To see how their rates rank in your area, click here.  Please keep in mind that Medicare Supplements does NOT cover long-term care, vision or dental care, hearing aids, eyeglasses, or private- duty nursing.  However, Medicare Supplements will cover the 20% that original Medicare doesn’t cover.

Some Medicare Supplement policies also offer coverage for services that Original Medicare doesn’t cover, like medical care you may need when you travel outside of the U.S. Please keep in mind that Medicare Supplement plans are DIFFERENT from a Medicare Advantage plan. 

If you have any questions, please call MWG Senior Services at (877) 759-5760 or email us at seniorservices@morganwhite.com.  Our knowledgeable and experienced representatives are ready to help guide you through the Medicare maze.

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

Drug Supply – Prescription Drug Plans

Recently we had a client call us to let us know that the co-pay originally quoted with the Humana Part D plan was twice as high as originally projected.  A little surprised and hoping we did not mess up when researching the drug supply, I asked him for the name of the prescription and the drug dosage.

Drug Supply Example

After looking the prescription up on the Humana Insurance and Medicare websites I noticed that the drug supply was accurate with what I originally told our client the co-pay would be (20% of the drug cost with a cost of $290 at his pharmacy).  After he read me his drug information I started realizing what the problem was.  The prescription was a 43 day supply – which meant the pharmacy was charging him in a  2 month supply.

All of a student his $290 (retail cost) drug with a 20% co-pay was being doubled because it was equivalent to getting a 60 day supply. We still needed to call the insurance company to verify this information, but this taught all of us an important lesson.

Part D Recommendation

  1. The first recommendation is review your Prescription Drug Plan every year.  These plans change and a good analysis is very important.
  2. The next thing is to make sure you get the full 30 day supply or 90 day supply.  Do not get a 35 day supply or you will be charged for a 60 day supply and this will cause you to be closer to the donut hole.
  3. Contact Medicare Insurance Finders for a free analysis of your Part D plan.  We give this review every year during the Annual Election Period to our Medicare Supplement clients.

Medicare Insurance Finders is based out of Jackson, MS but services the entire United States.  We have policy holders in just about every state and represent over 25 insurance companies to help you find the right plan.  Give us a call at 1-877-936-2991.

Drug Supply - Prescription Drug Plans

Providing advice on Medicare Supplements for individuals with health issues

Bermuda National Healthcare

This week I was in Miami and listened to several men speak who owned insurance agencies, insurance companies and even handled re-insurance with Lloyds of London from Bermuda.  These men began explaining how Bermuda had implemented national healthcare for their 60,000 residents roughly 40 years ago.  They said that it originally looked like what is happening in the United States with the Affordable Care Act.

Affordable Care Act

In a nutshell, the Affordable Care Act (ACA) has had pieces go into effect prior to 2014 but the main dish is coming in less than 12 months.  In 2014, enrollments for group health insurance plans will be done through an exchange and individuals will be allowed to enroll for individual coverage through these exchanges as well.

The ACA will require insurance plans to cover base benefits, no cap or maximum on coverage benefits, no health questions, and many other things.  Some of these things where not in effect with traditional health insurance plans or plans as we know it and these changes are expected to cause health insurance premiums to rise.  Some newspapers have reported increases by as much as 200%, while I think that is a little high 30% is definitely reasonable.

Bermuda National Healthcare

Back to the point of this article, the gentlemen from Bermuda filled us in on what happen in their country when national healthcare was imposed.  They said it was a rough 5 years being implemented.  Rate increases, hospitals had problems getting reimbursed and many other things of this nature.  Forty years later he mentioned that they just about have the kinks worked out.

There plan is similar to Medicare.  They have base coverage and then need a supplemental insurance plan to cover the deductibles, co-insurance, and co-pays that they experience.  The base plans have no health questions, no pre-existing conditions and other features that make this coverage very similar  They also have plans that are rich in benefits similar to the Plan F Medicare Supplement.

Bermuda Medical Facts

Bermuda actually has been recorded as having the second highest healthcare costs in the world.  There plan also does not cover foreigners visiting the country.  Individuals are required to purchase health insurance to cover their own expenses and must be aware if their coverage offers benefits outside their country of residence.

 

Medicare Insurance

If you are coming up on retirement or the big 65 you probably have questions about Medicare Insurance. In this article and throughout our website we explain the basics of Medicare and what you need/want to know about the coverage and premiums associated with this health insurance.

If you read this article and visit our website and still have specific questions about Medicare insurance give us a call or reply to the post in which you have questions.  We will do our best to give you the information.  If you are  just in need of Medicare Supplement insurance click here for a free quote in under 2 minutes with over 25 Medigap Insurance Companies. Continue reading

Health Insurance Exchange

The Affordable Care Act is underway with a launch date of the health insurance exchange to be kicked off in October of 2013.  This launch date is not when the actual insurance programs will take place but the Open Enrollment period for a January  2014 start date.

Several questions we have received is will my Medicare Supplement have to be purchased through the exchange?  What is an exchange?  A Health Insurance Exchange is simply a marketplace for individuals to go and purchase insurance.   These exchanges will be operated by each state but they may be operated by the state itself, the federal government, or by partnerships.   Continue reading

Extended Care (Skilled Care) Services of Medicare

Over a million Americans each year are denied access to Extended Care (skilled care) services of Medicare, if they were not classified as “admitted” when they go to the hospital.  We are well aware of the problem, but clients seldom are.  CMS has come down hard on hospitals for “upcoding” to admitted status to receive a higher payment for their services, than they would if they were coded as observational status.

Sometimes we overlook important matters like this, but one gentlemen , Lance of a Midwest state, has experienced this situation.  Lance got a call from the daughter of one of his Med Supp policyholders describing exactly what is being discussed.  Lance took the time to carefully interview his client’s daughter, and forwarded the conversation to me.  Lance gave permission that this information could be shared and we are doing so because I think his work is so well done, and so complete, that you will be able to utilize it should such a situation develop for you. Continue reading