Medicare May Be Raising Costs to Beneficiaries in 2016

It is projected (not finalized until later in 2015) that both Medicare Part B deductibles and Medicare Part B premiums will have a significant increase for 2016. According to the 2015 Medicare Trustees Report, it predicts that Part B premiums will increase from $104.90/mo. to $159.  However, since current Medicare beneficiaries will not be getting a Social Security cost of living raise in 2016, their premiums will remain stable.  It is new Medicare recipients that will be paying the $54 per month increase.  However, everyone should expect that the Part B – $147 deductible that has stayed the same for a number of years, will jump to $223 per year.  This may not immediately impact those who have other insurance that covers the Part B deductible this year.  But, ultimately, it will justify premium increases in the future.

We are also seeing increased costs in the Part D prescription plans for 2016.  Many plans are raising the deductibles and cost of the premiums and co-pays.

Important things to know about Annual Enrollment

Annual Enrollment Period, (AEP) also know as Open Enrollment Period (OEP) is from October 15, 2015 until December 7, 2015.

  • All Medicare Advantage Plans and all Prescription Drug plans will change for 2016.  Medicare supplements (Medigap) benefits will stay the same and automatically renew.
  • It is important to “shop” for a plan for 2016.  This can be done at www.Medicare.gov or by contacting a reputable insurance agent that represents numerous plans.
  • Your existing insurance plan is required to let you know by letter what changes will be made for 2016.
  • If you are satisfied with your existing coverage, it will automatically renew for 2016.
  • If you want to change plans, this OEP is the time to make the change.
  • Part B premiums will be going up for new Medicare beneficiaries.  This will not affect existing Medicare recipients.

 

Recognition from AARP Medicare Plans from United Health

It is an honor indeed, to have AARP Medicare Plans from United Healthcare recognize me as a level 2, “Authorized to Offer” agent.  Every “A2O” agent is required to meet rigorous criteria to become “Authorized to Offer” status.  Even though I pride myself on being a professional to all my clients and the insurance companies that I represent, it is this particular company who recognizes that professionalism.  In order to qualify for this I had to meet certain standards and ethics.  Some of these include:

  • Demonstrated competency and experience requirements
  • Commitment to community service
  • Required agent training on product, ethics and needs analysis, as well as regulatory training requirements
  • State licensure
  • Annual disciplinary history and background check review, including third-party credit and criminal checks

I must:

  • Requalify every year
  • Sign a code of Ethics
  • Protect consumers through required Errors and Omissions insurance
  • Not engage in door-to-door marketing or cold calling
  • Meet with you in the place of your choice
  • Place you with the best product for you.  I am commission “neutral” meaning I don’t push you to a product that pays me the most.
  • Give you a clear explanation of who you are doing business with
  • Clarify all consumer disclosures and provide you with the limitations and exclusions of product

It is important to you because an “Authorized to Offer” agent:

  1. Can provide you with personalized service and can assist in finding solutions to fit your needs.
  2. Can address the complexity of many of the insurance and financial products AARP members may need in order to have protection and a sense of security.
  3. Can meet with you in-person to address your specific questions and concerns and can lead to a more thorough understanding of how the solution addresses your unique needs.

You can expect me to be a trusted professional and practice four core principles:

  1. Approach every interaction with integrity
  2. Put client needs first, even if it means recommending a product not branded by AARP
  3. Be an expert and stay informed
  4. Display a commitment to the community.

For further information, please refer to the official Introducing “Authorized to Offer” Local Agents brochure (You will need Adobe Reader installed on your computer to view this document. Adobe Reader is available for free here.)

Two Words Can Cause Medicare Patients Thousands of Dollars!

You could get caught owing many thousands of dollars even though I have sold you the best coverage available.  This is due to two little words in your hospital medical chart – “Under observation”.  Make sure that if you go to the hospital and stay there, that you are actually “admitted.”  NBC News explains it in this segment video (click on the word segment to see it.)

 

Unhappy with your Medicare Advantage Plan?

For those who enrolled or were re-enrolled in a Medicare Advantage plan for 2014 and are having “issues”, there is a way out;  But you need to act before February 14, 2014. Maybe your doctors are not in network, or a prescription you need is not covered. The government wants you to stay in your plan the whole year but will let you out in this special time called the Medicare Advantage Disenrollment Period (MADP).

It is important to know that this will return you to original Medicare.  You do have a guaranteed right to get into another prescription plan.  In addition, you may be able purchase a Medicare Supplement or other Medigap policy if you qualify. You may not enroll in another Medicare Advantage plan for this year.

If you are confused or want clarification, please feel free to contact PQ Wallace Insurance for a no obligation consultation. 757-232-4678 or pqwallace@pqwic.com.

 

 

 

 

 

 

 

 

 

 

 

Newport News Shipyard Retirees Losing Medicare Coverage

I am concerned about the amount of “unease” and lack of choices being expressed by retirees of Newport News Shipbuilding about the loss of their supplemental Medicare coverage.   There been several articles in the Daily Press about the letters that Huntington Ingalls Industries sent to their former retirees informing them that they need to use ExtendHealth to counsel them about their Medicare options.

I wish to share some important information that should have been explained to those affected.  I can offer this information because I have a reputation as a Medicare insurance “subject matter expert.” I am a licensed independent insurance agent who has specialized in helping Medicare eligible beneficiaries over the past 9 years, understand all the options available in the local market.

Because these Medicare eligible retirees are losing their supplemental insurance through no fault of their own, Medicare requires that insurance companies that offer Medicare Supplements, Medicare Advantage Plans and Prescription Drug Plans, offer plans that are guaranteed issue.  In other words, the retiree can purchase, an excellent plan, regardless of existing medical conditions, at a more competitive premium. Many of the plans use Medicare as the primary insurance and as long as a doctor or healthcare provider “accepts” Medicare, the Medigap plan will pay most, if not all the remaining charges. There is no need to worry about networks and the medical coverage will be as good as what they now have.

The prescription drug coverage, however, may or may not be as good. All reputable agents “shop” for the best prescription plan to meet each individual’s needs.  However, all of the available plans are subject to a gap in coverage, also known as the “donut hole.” The Centers for Medicare and Medicaid (CMS) will not allow any marketing of the approved 2014 plans until October 1, 2013.  This explains ExtendHealth’s reluctance to discuss specifics until then.

What remains unclear to me is whether the retirees must go through ExtendHealth in order to receive any funds from their retiree reimbursement accounts. If this is the case, then obviously HII is limiting the retirees’ choice of using a local, knowledgeable, reassuring and face to face agent.

Confused about Medicare?…. This may help!

Almost every day, I talk with people aging into Medicare. Almost everyone is confused. One reason is that there at least two names for exactly the same Medicare feature.  For example:

A Medicare supplement is the same thing as a Medigap policy

Medicare Part A is inpatient hospital and nursing home insurance

Medicare Part B is medical insurance (doctor, lab, x-ray, ER, etc.)

Medicare Part C is also known as a Medicare Advantage Plan or MA or MAPD (includes a PDP)

Medicare Part D is a prescription plan also known as a PDP

A Gap in prescription coverage is also known as the “Donut Hole”

A low income subsidy (LIS) to help pay for prescriptions is also known as “Extra help”

There are 4 parts to Medicare: Parts A.B,C, and D but confusingly enough when shopping for a Medicare Supplement policy,  you have eleven plans to choose from: Medigap Plans A, B, C, D, F, high deductible F, G, K, L, M, and N.

The Government branch – U.S. Department of Health and Human Services, Centers for Medicare & Medicaid (known as CMS) tries to be helpful.  They have a wonderful publication Medicare & You that is only 140 pages long. It has been my experience that you only get this resource after you have Medicare and even then, very few people will read or understand it.  That is where I come in!  I know and understand this information! However, I do use a flow chart found on page 14, to show my prospective clients.  I find this visual to be very informative. You may find this  Medicare Chart on a separate page on my website.

As always, please feel free to contact me with any questions.  My knowledge is absolutely free to you with no obligation.

 

Original Medicare Benefit Coverage

What is the difference between a Medicare Supplement policy and a Medicare Advantage policy?

They both are meant to enhance Original Medicare (Part A and Part B) benefit coverage. However, they are distinctly different and can not be interchanged.

A Medicare Supplement (also known as a Medigap policy) is purchased for a premium from a private insurance company. The plans are standardized and a good plan (such as Plan F) will basically cover all medical expenses that are not covered by Original Medicare.

Medicare Advantage Plans (also known as Medicare Part C), are plans that are contracted with the Center for Medicare and Medicaid (CMS). You enroll in a specific plan managed by an insurance company. That plans then is responsible for paying for your medical expenses. You are responsible for co-pays and co-insurance.

These plans have to be ,by law, be as good as or better than Original Medicare. They may include extra benefits such as a built in prescription drug plan and discounts on medical related services

MEDICARE

Medicare provides health insurance to those individuals age 65 and older and those who qualify because of a disability.  Medicare is a good basic insurance but does not cover everything. Medicare beneficiaries are highly encouraged to buy a prescription drug plan, also called Medicare Part D.  Most also want to purchase additional coverage to fill in the gaps that original Medicare does not cover. This coverage is also know as a Medicare supplement or a Medigap policy and can be purchased with varying levels of coverage and cost.  Those with Medicare can also choose to receive their benefits through a Medicare Advantage Plan.

All of these choices and options can be confusing to those looking for coverage.  Paula is a subject matter expert in Medicare and represents many insurance companies that sell Medicare Plans.  She can help you figure out what is the best for you.  The insurance companies pay her a commission.  Therefore, there is no cost or obligation to use her consulting services.

Paula is contracted or authorized to sell from the following companies.

Medicare Supplements/Medigap Policies

  • AARP/United Health Insurance
  • Aetna
  • American Continental/Aetna
  • Anthem Blue Cross and Blue Shield
  • Cigna
  • Gerber Insurance
  • Medico
  • Omaha Insurance Co/Mutual of Omaha
  • United American
  • Woodmen of the World/Assured Life

Medicare Advantage Plans

  • AARP/Secure Horizons/United Healthcare
  • Anthem Blue Cross and Blue Shield
  • Today’s  Options/Universal American/Pyramid

Medicare Part D Prescription Drug Plans (PDPs)

  • AARP/United Healthcare
  • Aetna
  • Anthem Blue Cross Blue Shield
  • Cigna
  • First Health/Coventry
  • Silver Scripts
  • Wellcare