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• Health Care Reform for Medicare Beneficiaries

  8:24 am on March 23, 2010 Permalink | Reply
  Tags: health care reform, Medicare

  What does the health care reform bill mean for Medicare beneficiaries?   

  There’s some good news for those with heavy prescription drug bills and some things to think about for those using Medicare Advantage plans.   

  Here are some of the highlights for those covered (or soon to be covered) by Medicare: 

  The “doughnut hole” – It’s been the nemesis for those with heavy prescription drug bill and Part D coverage.  The doughnut hole is the coverage gap in which seniors must pay the full cost of their prescription drugs- $2380 – $4550 in 2010.  Beginning in 2011, the bill gradually closes the gap until it disappears in 2020.

   $250 rebate gap coverage– In 2010 only, for those who hit the “doughnut hole” there will be a one-time $250 rebate. No details yet on how that will work, but we will cover it in MomentumToday as soon as the announcement is made. 

  Brand Name Drug discounts – Beginning in 2011, brand name drug prices will be discounted 50% during the part D coverage gap.  The discount will be increased until 2020, until the benefit reaches 75% of the cost.

  Medicare benefits — More preventative services will be part of standard Medicare coverage including cancer screening and a once-a year wellness exam. 

  Medicare Advantage plans – The law reduces payments to Medicare Advantage plans beginning in 2011.  So insurance companies will face two choices:  higher premiums or a reduction in benefits for these plans which combine hospital, doctor and drug coverage. 

  At MomentumToday, we’ll be highlighting how these changes impact the insurance decisions of Medicare beneficiaries going forward.  We’ll also be digging into the legislation to see what else might impact your budget and planning in the years ahead.   

  If you are new to Medicare, you’ll want to carefully weigh whether Medicare Advantage or Medicare supplement and Part D is the right choice for your health care needs.  While we don’t know exactly what changes are ahead for Medicare Advantage plans, it’s important to understand the trends and pressure on the insurers and how that could impact your coverage in the future. 

  For those already covered by Medicare, beginning in the fall of 2010 shopping for 2011 Part D and Medicare Advantage plans will be important so that you can assess plan changes and see if you have the right Medicare insurance plan going forward.

  
   

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• New to Medicare? It’s Smart to Compare Medicare Insurance Plans

  12:10 pm on January 25, 2010 Permalink | Reply
  Tags: Medicare, Retiree health insurance

  Most of the time we buy health insurance through our employer, often life and disability insurance as well. 

   So, what happens as you approach 65 and no longer have an employer to purchase through and don’t have retiree health benefits and need to select a Medicare health plan?

   You are on your own.

   Your benefits office may have some guidance for you, the Internet can serve up an often dizzying choice of plans and your mailbox will probably start filling up with “turning 65” offers. And health care can be one of your biggest expenses in retirement, so selecting the right plan is important.  

   Here are 3 tips for finding your way through the Medicare health plan maze:

  1. Don’t Assume Your Current Insurer is the right choice for your Medicare Plan.

  Not all companies offer all plans.  Some health insurance companies offer either Medicare Supplement or Medicare Advantage plans, others offer both.  Those who offer Medicare supplement plans may offer only a few – the most popular–of the standardized plans available.

  If you are selecting a Medicare Advantage plan check and compare plans carefully to see what is included and not included.  If keeping your current doctors is important, start by comparing plans from companies that your doctors accept. Then compare co-pays, premiums and benefits.

  2. Shop and compare prices. Medicare supplement plan prices vary widely. 

  Medicare Supplement plans are standardized.  That means each company must offer identical benefits.  It doesn’t mean they have to charge the same price…and prices can vary a lot.  So once you decide on which plan (by letter Plan A, Plan B, Plan F, etc.) then get prices for that plan from 2 to 3 different insurance companies.

  3. Compare benefits and premiums.

  It’s not just the premiums when it comes to comparing Medicare Advantage plans and Medicare Part D plans.  You’ll want to look at co-pays, premiums, and additional benefits.  For example, some Medicare Advantage plans come with benefits like free health club membership.  If that’s not important to you, look at a plan without that benefit and see how it measures up. 

  The Medicare website has tools that help you compare plan details as well as prices.  This also might be the time when you want to contact an expert in Medicare health insurance plans to help you find the right plan.  Your local area office on aging has resources that may be helpful.  Or contact an insurance broker who specializes in Medicare health plans and has a choice of companies for you to consider. 

  Insurance rates are approved by each state’s  insurance commission.  So unless you are looking at a plan designed and marketed by a specific group (like an association), whether you receive a quote from the company directly or the agent, the rate for an identical plan should be the same.   So you can save yourself some time and effort by finding a source that can quote you plans from a variety of companies.

  So as you approach 65, start gathering information and make sure you know the sign-up deadlines so you don’t get hit with a penalty. 

  If you are 65 and still working, contact your benefits office to find out how your health insurance works with Medicare. 

  The Medicare  and You 2010 book can help you get familiar with the ins and outs of Medicare.

  
   
• Extra Help with Medicare Prescription Drug Plans

  12:11 pm on January 11, 2010 Permalink | Reply
  Tags: Medicare

  For some Americans who are enrolled in Medicare and have trouble paying their prescription drug costs, a change in the law might bring some welcomed help.  It’s called the “extra help” program and is available to those with low income and limited resources. 

  The extra help program currently provides assistance to more than nine million senior and disabled Americans — saving them an average of almost $4,000 a year on their Medicare prescription drug plan costs.  

  Beginning Jan. 1, a new Medicare law eases the income and resource requirements in two ways:

   1 It eliminates the cash value of life insurance from counting as a resource.  

   2. It eliminates the assistance people receive from others to pay for household expenses, such as food, rent, mortgage or utilities, from counting as income. 

  The Extra Help program can pay for the costs–monthly premiums, annual deductibles, and prescription co-payments–related to a Medicare prescription drug plan. To qualify for Extra Help:

  • You must reside in one of the 50 states or the District of Columbia.
  • Your resources must be limited to $12,510 for an individual or $25,010 for a married couple living together. Resources include such things as bank accounts, stocks, and bonds. Your house and car do not count as resources; and
  • Your annual income must be limited to $16,245 for an individual or $21,855 for a married couple living together. Even if your annual income is higher, you still may be able to get some help. Some examples where your income may be higher are if you or your spouse:

                            * Support other family members who live with you;

                             *Have earnings from work; or

                             *Live in Alaska or Hawaii.

  If you or someone you are caring for could benefit from the program, more information and an application form are available at the Social Security website or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

  
   
• Have to Find a New Medicare Plan? Start Looking Now!

  3:13 am on October 12, 2009 Permalink | Reply
  Tags: Medicare, Medicare Advantage (3), Medicare Part D (5), Medicare supplement

  Across the country hundreds of thousands of people are finding that the Medicare health plan they have is being discontinued.  Other looking at higher rates next year for medicare Advantage or Part D plans wonder if there is a more affordable Medicare plan available. 

  Some of the plans that have been impacted are Medicare Advantage plans .  Those are plans that require you to use a network of doctors.  But they also usually include prescription drug coverage, dental, vision or even gym club memberships. For example, Blue Cross Blue Shield of Texas has announced it wont be renewing its Medicare Advantage Blue Medicare PPO contract.  Many private-fee-for-service (PFFS) plans have been discontinued. Coventry, HealthNet and Aetna are among the companies that said they are leaving the private fee-for-service market effective Dec. 31.

  So what are your options? 

  • Consider another plan from the same insurance carrier,
  • Look at similar plans from other insurance carriers, or
  • Look at a different type of coverage – perhaps Original Medicare (Part A and Part B) with a Medicare Supplement plan and a Part D prescription drug plan. 

  How do you know what’s right?  Know the differences between the two types of plans.  Then, start shopping.  The annual  election period for Medicare Part D plans and Medicare Advantage plans has started.  If your plan is being discontinued you have a special election period that began Oct. 1 during which you can return to Original Medicare and apply for a Medicare supplement plan that would be effective Jan. 1.   For these particular situations you may be able to apply now — you don’t have to wait until Nov. 15.

  If you are seeking to change plans because of personal preference, you can’t apply for a new policy before Nov. 15, you can start requesting information and comparing the options. 

  Confusing?  It can be, so get started right away and begin by knowing your deadlines.  When you speak with insurance companies and insurance brokers now, they have more time to go through the options with you.  Prices from different carriers can vary widely, so make sure you compare at least 2 or 3 companies.

   Here are five tips to get you started:

   1.  Start shopping right away if your plan is cancelled or you have seen a significant increase in prices.  First, decide what type of plan are you looking for:  Medicare Advantage,  or Medicare Supplement + Part D? Medicare Supplement usually gives you more choices but can cost more.  Medicare Advantage plans require you to use a network of doctors. Depending on whether you current plan is being cancelled, you may be able to go ahead and apply right away.

   2. Contact a broker who specializes in Medicare and has a choice of companies.  Or go to http://www.Medicare.gov and try the comparison tools to identify different companies. If you have a PFFS plan and it has been cancelled, you probably have guaranteed issue provisions that allow you to move to a Medicare Supplement plan without the normal underwriting restrictions.  Ask your agent to check.

   3.  Read the material.  Especially if you are switching from a Medicare Advantage Plan or PFFS (private-fee-for-service) plan to Medicare Supplement and Part D so that you understand the differences in premium costs, out-of-pocket costs and benefits.  Make a list of what’s most important to you in the plan you have and have it handy as you read through different plan options. If you are swithcing to a medicare supplement plan, make sure you know whether or not you will have to go through underwriting to qualify.

   4.  Know what type of insurance your doctor takes.  If you want to stay with the doctor’s you have, or having access to certain hospitals is important to you, check to find out which plans they take. 

  5.  Don’t wait.  The sooner you understand the choices and compare costs, you’ll be ready to apply now or by the Nov. 15 deadline.   

  It is stressful having to replace a health insurance plan, especially when you weren’t planning on it.  Upfront planning can help ease the stress and give you time to make sure you’re making the right decision for 2010. 

  Resources:

  Previous Post on 2010 Medicare plans

  Read this article from the Philadelphia Inquirer about policy cancellations.

   Medicare Website for Comparison Tools

   Read the CMS announcement

  Longevity Alliance Medicare Health Plan Information

  
   
• Medicare Part D and Medicare Advantage in 2010

  9:08 am on October 5, 2009 Permalink | Reply
  Tags: Medicare, Medicare Advantage (3), Medicare Part D (5)

  If you are one of the 11 million people enrolled in a Medicare Advantage plan, now is the time to review your plan and make sure it meets your health care needs. Also, it is time to shop and compare if you are one of the nearly 27 million people enrolled in stand alone Part D prescription drug plans.

  You’ll be seeing a lot more advertisement about Medicare plans over the next several months.  That’s because we are in what is called the “Open Enrollment Period” for Medicare beneficiaries. Marketing began Oct. 1, and you’ll be able to begin applying for a different plan, if appropriate, beginning Nov. 15. The rules and timeframes are a bit different for Part D and Medicare Advantage (see timeline at the end of the article).

  How important is this?  Pretty important if you have had changes in your medical condition over the past year and or been notified of major changes in your plan for 2010.  Also, some plans are being withdrawn from the market – notably plans called private-fee-for-service (PFFS) plans. Medicare estimates about 700,000 people will have to change because plans are no longer available.

  How do you know if you are impacted by any of these changes? You receive an Annual Notice of Change from your health plan that will alert you to changes in plan availability, price and/or coverage.

  For Medicare Advantage plans, the average premium increase is $39, up about $7 from last year, according to the Centers for Medicare and Medicaid Services (CMS).  But, plan changes vary widely by region.  For example, according to an analysis by the Kaiser Family Health news, those enrolled in the least expensive Blue Cross plan in Philadelphia will see their premiums go to $52 from zero.   So, don’t set it aside –read you Annual Notice of Change.

  So, what steps should you take this open enrollment period?

  1.  Read your Annual Notice of Change when it arrives from your Part D or Medicare Advantage plan.  Take note of changes in premium, benefits and co-pays, if any.  That way you can determine the real cost of changes to your policy.

  2.  Significant health changes in the past year can be a trigger for plan comparisons. If you have had significant changes in your health, particularly in your prescription drugs, you might want to check and see if there are other plans that would be better now. It could be a different plan from the same company or a totally different insurance company

  3.  Compare.  There are many tools available for comparing plans and prices: Part D compare on the Medicare site  Also, you can check with an insurance  broker who represents a choice of companies.  They can compare plans for you.  Make sure you have your current plan information and a list of the prescription medications you are currently taking.

  4.  Watch the deadlines.  Don’t wait until the last minute to apply if you are going to change plans.  Applications can be taken beginning Nov. 15.  So October is a perfect time to do your comparison shopping.

  More information about open enrollment from Medicare  

  Important Dates for 2010 Medicare Advantage & Part D Rx Drug Enrollment

  October 1 – Marketing begins for 2010 Medicare Advantage & Part D Rx Drug plans

   November – “Medicare and You 2010 ” arrives in the mail from Medicare

  November 15th – Annual enrollment begins for Medicare Advantage & Part D Rx Drug plans

  December 31 – Enrollment deadline for 2010 Part D Rx Drug plans.

  March 31 – Enrollment deadline for switching Medicare Advantage plans for remainder of 2010.

  
   
• Retirement Resources Outside the Workplace

  6:19 am on September 14, 2009 Permalink | Reply
  Tags: Medicare, Retirement (2)

  So what do you do if your employer is not one of those exemplary employers for people over 50? Many companies have cut their pre-retirement resources to the bone so people who might have been able to help you with retirement questions are either gone or overloaded with other work.  

  Still, the first thing to do is check with your Human Resources staff for guidance and referrals.  This is particularly important if you are continuing to work but are approaching 65 and need to sign up for Medicare.  Understanding how your employer health insurance works with Medicare is really important.

  Then, check these 3 places to get help with retirement decisions outside the workplace:

  1.  Government Resources – If you have questions on Social Security or Medicare the government websites have lots of information.  You often have to keep poking around to find the right information, but there are brochures and Q&As to help you understand how the programs work, how they interact with employer benefits or pay if you are still working. The estimator tool on the Social Security site is excellent and will show you the impact on your benefits if you take benefits early.

  2.  Local Resources – Check out your public library for information and also helpful seminars.  Find the local senior center in your area and find out what services or workshops they have coming up.  Many senior centers are actively creating programs to attract baby boomers and near retirees, so don’t be put off by the word ‘senior.”

  3.  Professional Experts– Seek out professionals who can assist you. Make sure they have expertise in this stage of life.  For a fee, financial planners or advisers can help you figure out not only your financial situation but also make recommendations and referrals about other aspects of retirement living. Companies like Longevity Alliance,which specializes in pre-retirement and retirement products like long-term care, Medicare plans and annuities, can help you sort through the options and products to find solutions that meet your needs.

  
   
• How Do You Stretch Your Retirement Plan to Help Others?

  7:08 am on September 9, 2009 Permalink | Reply
  Tags: aging parents, annuities, long-term care insurance (4), Medicare, retirement planning (6)

  It makes sense that our retirement plans focus on funding our life in retirement.  But, the fact is that more of us than ever are lending a financial hand to family members – an expense we probably didn’t include in our plans.

  Almost half of retirees are helping financially support others, either by giving them money or helping them manage their money, according to new research. Children (53%) and grandchildren (37%) top the list of dependents.  Another 12% are contributing to their parents finances, according to the Real Life Retirement Survey by Charles Schwab & Co.

  So what should you do if you find yourself feeling financial pressures from all sides?

  1.  Take Care of Your Retirement Risks First. Anytime you fly with a dependent you are told that in case of an emergency to put your mask on first, and then help your dependent with their mask.  Same goes for finances.  It’s hard to help others if you are putting yourself at financial risk.  So take a look at not just your retirement nest-egg, but also what plans you have in place to cover risks in your retirement.

  For example, long-term care risks can be covered by long-term care insurance. Covering your future risk now can make you feel more secure in helping aging parents with their needs today.  Longevity Alliance believes that by taking steps to proactively manage risk, peace of mind about your financial future is possible.

  2.  Helping Your Parents. Thanks to better medical care and drugs many of us are living longer than we ever expected – or planned for.  That means finances might be falling short, especially if there are unplanned for health care or long-term care expenses.  How can you help your parents?  It begins with understanding what they have and making sure that it is being employed in the best possible way.  Schwab recommends steps such as helping them establish a realistic budget, and checking their Social Security and Medicare.

  As you check their Medicare coverage, see if their plans (Medicare Supplement, Part D or Medicare Advantage plans) are still a good fit with their health conditions.  With open enrollment season coming Nov. 15 for Medicare Advantage and Part D it is the perfect time to shop and compare plans.

  An immediate annuity might be a solution for those concerned with outliving their money.  An immediate annuity turns a fixed amount of money into a stream of payments for a lifetime.

  3.  Help the kids last. Hard as it may be to put them last on the list for help, they are the ones that have the longest time to recover from the current economy.  They have time to build their retirement savings and watch it grow – and to repay student loans.  This can also be a great opportunity for them to learn firsthand the importance of good savings and spending habits.

  This economy has shown us that the unexpected can happen – and change our plans dramatically.  And while we do what we can to help support others, managing our own retirement risk first will help assure that we won’t be a burden to our family in the future.

  
   
• Good News on Medicare Part D Rates

  9:13 am on August 18, 2009 Permalink | Reply
  Tags: Medicare, Medicare Part D (5)

  Medicare beneficiaries got some good news this week:  only a slight increase in rates on their Part D prescription drug plans in 2010.  The average rate paid is expected to increase to $30 from $28 in 2009 based on bids submitted by Part D plans, according to to the Centers for Medicare and Medicaid (CMS).

   “Although most Part D plan should have relatively stable premiums, all beneficiaries should compare their current coverage with the plans that will be offered in 2010 when information becomes available in October,” recommended Jonathan Blum, acting director of CMS’ Center for Health Plan choices.

   Premiums and benefits for Medicare Advantage plans and more details on Part D plans will be announced in September. Specific  rate and benefit information about plans is usually available in October and open enrollment period for Part D and Medicare Advantage plans begins Nov. 15.

  If you are turning 65 or shopping for a new Medicare health plan you can find more information at Medicare Made Simple.

  
   
• Signing up for Medicare at 65

  11:07 am on August 10, 2009 Permalink | Reply
  Tags: Medicare, Medicare+turning65, Medicre Advantage, Medigap Plans, senior health insurance

  Turning 65 is an age that for many signals a new phase of life…retirement, a new career, relocations, part-time work…to name just a few.  One of the biggest changes it brings is in health care coverage.  For many it marks a shift from employer coverage or self-insurance to a government sponsored program – Medicare.  It can seem like a maze but making the right decisions about your coverage is essential.  Here is a guide on what you need to do if you’re turning 65 this year.

  Most people qualify for Medicare when they turn 65. You qualify if you’re eligible for Social Security or Railroad Retirement benefits. Or you may qualify on a spouse’s (including a divorced spouse’s) record.  Others qualify because they are government employees not covered by Social Security who paid the Medicare part of the Social Security tax.

  Part A and Part B are two key parts of Medicare:  Part A (hospital insurance) helps cover your inpatient care in hospitals.  It also helps cover skilled nursing, hospice and home health care if you meet certain conditions.  Part B (medical insurance) helps cover medically necessary services like doctor’s services and outpatient care.

  If you are already getting Social Security benefits, you’ll automatically be enrolled in Medicare Parts A and B. However, because you must pay a premium for Part B coverage, you have the option of turning it down.  You will be contacted by mail a few months before you become eligible and given all the information you need. 

  You’ll find great information at http://www.medicare.gov and the “Medicare and You” booklet available online.

  Signing Up for Part A and B

  • If you get benefits from Social Security or the Railroad Retirement Board (RRB), you will automatically get Part A starting the first day of the month you turn age 65.
  • If you aren’t eligible for premium-free Part A, you can buy Part A during your Initial Enrollment Period—the 7-month period that begins 3 months before your 65th birthday and ends 3 months after your 65th birthday.
  • If you aren’t getting Social Security or RRB benefits (for instance, if you are still working), you will need to sign up for Part A. You should contact Social Security 3 months before you turn age 65 to sign up for Part A.
  • If you get benefits from Social Security or the Railroad Retirement Board (RRB), you will automatically get Part B starting the first day of the month you turn age 65. You will get your Medicare card in the mail about 3 months before your 65th birthday.
  • If you don’t want Part B, follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B.   

  More decisions to make

  Don’t be fooled into thinking your health coverage is now complete.   Original Medicare will not pay for all of your medical expenses. You may be liable for deductibles and coinsurances, and a prescription drug plan will be necessary to help you with your prescription drug costs.

  You can choose different ways to get your Medicare benefits. In most cases, if you do nothing when you are first eligible for Medicare, you will automatically be in the Original Medicare Plan, and you can join a Medicare Prescription Drug Plan. Or, you can choose to join a Medicare Advantage Plan (like an HMO or PPO) to get all of your Medicare benefits. In many cases, the Medicare Advantage plan will include Medicare prescription drug coverage.

  Here are some of the choices:

  • A Medicare Advantage Plan will usually provide more benefits than Original Medicare but may require that you use specific medical providers or may charge an additional monthly premium over and above your Part B premium.
  • A Medicare Supplement (or Medigap) plan will pay most or all of your out-of-pocket liability under Original Medicare, but will require a monthly premium in addition to your Part B premium.
  • A Prescription Drug Plan (Part D) provides Medicare Beneficiaries with assistance in paying for their prescription drugs. Medicare Prescription Drug Plans are offered by private companies and have varying benefit designs, premiums, co pays, formularies and participating pharmacies

  Make sure you know and meet the sign-up deadlines.  In many states, insurance companies offering Medicare Supplement plans  will ask medical questions (medical underwriting) for the purposes of accepting or denying your application for coverage or to set rates.  

  During the first 6 months after you turn 65 and enroll in Part B of Medicare, you have a Guaranteed Issue Period.  During this time you can enroll in any Medicare Supplement Plan offered by any insurance company in your state without having to answer medical questions. Your premiums during this Guaranteed Issue Period can not be based on any health conditions that you have. If you wait until after this Guaranteed Issue period, you may be required to answer medical questions and your application for coverage could be denied, leaving you liable for those expenses which Medicare does not pay.

  If you are in Original Medicare with or without a Medicare Supplement Plan, or in a type of Medicare Advantage Plan called a Private Fee for Service Plan, you will also have the opportunity to enroll in a Prescription Drug Plan.  All plans must meet minimum standards defined by the Centers for Medicare and Medicaid (CMS).

  If you do not have retiree benefits through your employer and are shopping on your own, make sure you get advice from a company that specializes in Medicare plans.