Category Archives: Medicare

2011 Choosing a Medigap Policy

Here is the 2011 Choosing a Medigap Policy This is the publication that is required for all Medicare Supplement purchases (Medigap).

Brian Services many Medicare Supplement (Medigap) policies, some of which you can check out online, others aren’t available online, but give Brian a call 800-240-3390 and let him compare them for you, even if you currently have a Medicare Supplement (Medigap)

Premera Blue Cross of Alaska

Premera Blue Cross of Washington

Lifewise of Oregon

How Healthcare Reform Will Affect Medicare

How Healthcare Reform Will Affect Medicare

On March 23, 2010 the Patient Protection and Affordable Care Act, better known as healthcare reform, was signed into law. Medicare beneficiaries have had many questions about how their benefits will be affected by the new legislation. For most people on Medicare, the changes will be transparent, and their benefits will continue to be delivered as they always have. The cost of the improvements in healthcare will be largely covered by reductions in fraud and waste in the system and by the elimination of the Medicare Advantage subsidies that have been in place up to this point. Below are some specific changes that Medicare beneficiaries can expect to see with the new law.

Medicare Part D

Currently, Medicare prescription drug plans have a coverage limit of $2,850. When drug costs reach that limit, consumers enter the "donut hole" and are obligated to pay 100% of the cost of their prescription medications. Customers stay in the donut hole until they have paid $3,610 in out-of-pocket costs, at which point they qualify for catastrophic coverage. Under the new law, the donut hole will gradually be eliminated between now and 2020. Starting in 2010, anyone entering the donut hole will receive a $250 rebate. In 2011, there will be a 50% discount on name-brand drugs while in the donut hole and a 7% discount on generics. The discounts will increase annually until the donut hole is gone.

Medicare Part B

Under Medicare right now, seniors pay a $155 annual deductible for Medicare Part B, which is the medical insurance part of Medicare. Beneficiaries also pay 20% of the cost for preventive care, including any tests or screenings, and annual physical exams not covered. In 2011, the 20% co-pay for preventative screenings for things such as cancer and diabetes will be eliminated. Also starting in 2011, an annual physical will be covered at no cost to the patient.

Medicare Advantage

Medicare Advantage plans were put into place in an attempt to privatize Medicare and have Medicare benefits provided by private insurers rather than the government. Medicare has been paying insurers a 10% subsidy which will be eliminated in 2012. Since this will result in greater costs for the insurance companies, it is likely that some plans will disappear, some will have higher premiums and others will have reduced benefits. Plans that are determined to be high quality by Medicare will receive bonus payments, however, that will offset the loss of the subsidy.

There are other changes to Medicare resulting from the new healthcare legislation, but these are the ones that seniors are most likely to be affected by. It is important for anyone aging into Medicare to read up on the benefits they are entitled to and to know what to expect. Detailed information on all aspects of Medicare can be found online at Medicare.gov.

Confused about Medicare-Based Health Insurance Options?

Confused about Medicare-Based Health Insurance Options?

Congratulations, you are turning 65. Now you are eligible for Medicare…and suddenly you are knee-deep in insurance decisions you have to make with little or no information to guide you. What is Medicare Advantage? Do you need Medigap? Do you need a Part D plan and if so how do you choose? Why are you paying premiums to Medicare and an outside insurance company?

Let’s start with a short history of Medicare. In the beginning, upon retirement or disability, there was no affordable insurance option available to most people.

Medicare started out as a government based insurance plan to cover the largest single cost in healthcare for the 65+ population – hospitalization. An inpatient hospital stay can easily run $15,000.00 a day. This part of Medicare, called Medicare part A usually has no premium requirement.

However, since many retirees have ongoing health issues and little income, Medicare added coverage for visits to doctors and diagnostic testing. This coverage, called Medicare part B, has a premium that you pay to Medicare. And more recently Medicare part D, which provides coverage for prescription drugs, has been introduced. 

Still, even between Medicare’s part A for hospital costs and part B for other healthcare costs, there are large gaps in Medicare’s coverage. So, in comes gap coverage insurance, otherwise known as Medigap.

Medicare was becoming a huge bureaucracy by this time. They needed to find a way to outsource this new option. At the same time, private insurance companies did not follow the same rules set down for Medicare. What could they do?

In the end, it was decided that private insurance companies could offer gap insurance, called Medigap, and collect separate premiums for it, but they had to use Medicare?s rules. This is why Medigap plan E through one carrier will give you exactly the same coverage as Medigap plan E through another carrier. This option is completely voluntary.

Medigap plans are secondary insurance. That means the bills go to Medicare first. After Medicare pays its share of the bills, they send the bills on to the Medigap insurance companies.

Unfortunately, these options, with all their premiums left a good portion of the 65+ population with insurance costs beyond their means.

Medicare’s solution to this problem was Medicare Advantage, sometimes known as Medicare part C. Medicare Advantage plans offer low premium plans sold by private insurance companies.

Medicare has given broad boundaries that insurance companies must comply with for these plans. In exchange, Medicare pays part of the costs incurred by the insurance companies to offset the lowered premiums.

Medicare Advantage plans are primary insurance. With a few exceptions, bills go to the Medicare Advantage insurance carrier, and the retiree is responsible for whatever portion of the bill that insurance company does not pay.

Still wondering which plan is best for you? Ask yourself a few questions:

* How much can you afford to pay in premiums on top of the Medicare part B premium?

The Medigap premium you pay will depend on the level of coverage offered by the plan you select.  The more comprehensive the coverage, the higher the premium.

* How often do you need to see a health care provider?

With Medigap plans, unless otherwise noted, coverage mimics that provided by Medicare itself.  So if Medicare imposes no limits on doctor visits, the Medigap plan will also not have any limits. But Medicare Advantage plans might have their own limits, but they also come at a lesser cost too. So, if you normally don’t see a healthcare provider very often – say twice a month – even with a couple of months that are more expensive, it averages out over the year to be less expensive.

* How much do you travel?

Medigap offers you the same coverage anywhere you see a Medicare eligible provider, whether you are visiting your sister in another state or at home. Most Medicare advantage plans, on the other hand, have very reasonable rates for seeing providers that are part of their local network, but have much higher costs for "out of network" providers, if they offer any coverage other than emergency room services outside of their local network at all.

Medicare and its many options, plans, and rules can confuse anyone. The best thing you can do is to get in touch with an experienced agent in your area who can help explain all of your options. Getting the Medicare plan that is right for you really is possible. Just remember, it is your right and responsibility to make an informed choice.

Keys to Living a Long, Healthy Retirement

Keys to Living a Long, Healthy Retirement

We are more knowledgeable than ever about healthy living habits and nutrition in this age of information and advances in medicine. Consequently, our average life expectancy keeps climbing. One hundred years ago, our life expectancy for was only 49 years, but now it is 77.9 years.

If you are going to live a long time, it is important to have a good quality of life in those extra years to be healthy and happy. You can live a longer and happier life if you follow some simple healthy habits. When you are retired, you want to enjoy your life, and being healthy contributes to that enjoyment. It is never too late to acquire new habits.

Smoking is possibly the hardest habit to break but also the most important one. Even if you have smoked for many years, you will decrease your risk for developing heart disease by 50% in just one year if you quit smoking. Stay away from second-hand smoke too, because it causes many health problems as well.

Eating a healthy diet and maintaining a healthy weight are important factors in living a longer, healthier life. The American Heart Association advocates eating an assortment of vegetables, fruits and grains, especially whole grains. Get your protein from fish, skinless poultry, lean meat and legumes. Consume dairy products that are low fat or fat-free. Fats and oils should be in the form of tub or liquid margarines, canola oil or olive oil.

Caffeine can upset your sleep patterns and strain your kidneys, so limit coffee and tea to one or two cups a day to help avoid the risk of serious illness.

A small amount of wine every day may actually be good for you, but moderation is the key for people of any age. Alcohol has a stronger effect on people as they get older, so be careful about the amount you consume. A small glass of wine with dinner should be just about right.

Before retirement, you may have felt that you were too busy to exercise, but this is a good time to develop a regular exercise program. After you retire and your life slows down, you probably have more time to devote to exercise. Research has shown that even people who do not start exercising until they are older can gain many of the same benefits for their health as people who have been exercising for many years, so don’t be discouraged if you are getting a late start.

Scientists believe that exercise helps to offset side effects from cancer treatments and helps people to control and manage diabetes, asthma and fibromyalgia symptoms. Regular exercise also helps you to stay fit and maintain a healthy weight.

Older people find that they can climb stairs, carry packages, shop and perform other physical tasks more easily if they exercise regularly. Exercise also helps older people deal with arthritis, condition their hearts and lungs and increase muscle mass and muscle strength.

If you want to live a long, healthy retirement, develop good exercise and eating habits, be patient and persistent, and you should see the results of your efforts before long.

Tips to Maximize Your Social Security Benefits

Tips to Maximize Your Social Security Benefits

A married couple, or an unmarried couple who were previously married for at least 10 years, combine their working records, for the purposes of Social Security benefits, while they are both living. With careful planning, a couple can maximize their benefits in ways that are not available for single people.

Claim Deceased Spouse’s Benefits

If your spouse is deceased, you are eligible to receive his/her full retirement benefit when you reach the age of 60. If you are disabled, you only need to be 50 years old to collect. If you claim benefits before the full retirement age of the deceased, they can be decreased up to 28 ½ percent. However, you could choose to ask for the lower benefit on your deceased spouse’s working record when you reach 60, and change to your own full benefit when you reach your full retirement age.

Claim Ex-Spouse’s Benefits

If you are at least 62 years old and were previously married for at least 10 years to the same person, and unmarried now, you could be entitled to collect benefits from your ex-spouse’s earnings. The amount that you collect will not decrease the amount that your ex-spouse receives.

Claim % of Your Spouse’s Benefits

A spouse can collect 50% of the amount of his/her spouse’s benefit if that would be more than his/her own benefit amount. You must have reached your full retirement age to collect that amount. If you apply at the earliest age you can, which is currently 62, you will only receive 35% of your spouse’s benefit amount. Note that the higher earning spouse must apply for Social Security benefits before his/her spouse can receive spouse’s benefits.

If the higher earning spouse has reached full retirement age, he/she may apply for the benefits and then ask to have them postponed. In this way, the spouse who earns less can apply for the spousal benefit while his/her spouse keeps working until age 70 to earn more credits. Each year that you postpone claiming benefits after reaching your full retirement age adds approximately 7 and 8 percent to your retirement checks when you apply at age 70. Note that there is no advantage in delaying benefits past the age of 70.

If you and your spouse are both past your full retirement age, you can draw based on your spouse’s benefits and keep working and accumulating credits on your Social Security record. You can then claim benefits on your own work record when you reach the age of 70 and get a larger monthly check because you deferred your credits.

If you can increase your benefits by any of these methods, it is worth a phone call or a trip to your nearest Social Security office.

Medicare PDP Rate Increase for 2011

According to several news sources Medicare PDP (Prescription Drug Plan) rates will rise around 3% on average.  Those same news sources are claiming that the coverage gap will shrink.