MEDIGAP MADE SIMPLE. By Rick Teska Rick Teska. All Rights Reserved

Transcription

1 Ne! w MEDIGAP MADE SIMPLE By Rick Teska 2017 Rick Teska. All Rights Reserved

2 Medicare Made Simple By Rick Teska WELCOME! Thank you for downloading our Medicare Made Simple Kit, we hope it is a helpful resource for you. We believe Medicare education is an important aspect of reducing stress and frustration when looking for the right plan. The Medicare system can become expensive due to its complexity, however with the right guidance and support the stress and extreme expense can be avoided. At Senior Market Solutions, we help clients find and apply for the perfect Medicare plan. We are a full service broker with no costs to the clients we help. Our flexibility of meeting clients at home, in the office or making telephone calls, provides them comfort and reassurance. We handle all of the paperwork and together we are able to find the best plan for them. Please feel free to ask us for help. Call us at: Or send us an at: info@seniormarketsolutions.com ABOUT SENIOR MARKET SOLUTIONS We are an independent Medicare brokerage. Senior Market Solutions represents many of the best Medicare supplemental insurance companies in today s market. As an independent broker, we do not work for an insurance company, we work for you! We provide you with customized quotes for the supplement coverage you need. When the time comes to find affordable and reliable coverage options, Senior Market Solutions is here for you. Thank you, enjoy! Rick This PDF is Interactive. Click links to learn more online Rick Teska. All Rights Reserved

3 HOW MEDICARE WORKS Medicare is health insurance for people 65 or older and people under 65 with certain disabilities. Click here to watch the video What are the different parts of Medicare? Medicare Part A (Hospital Insurance) helps cover : Inpatient care in hospitals Skilled nursing facility care Hospice care Home health care Medicare Part B (Medical Insurance) helps cover : Services from doctors and other health care providers Outpatient care Home health care Durable medical equipment Many preventive services Medicare Part C (Medicare Advantage) Includes all benefits and services covered under Part A and Part B Sometimes includes Medicare prescription drug coverage (Part D) as part of the plan Run by Medicare-approved private insurance companies that follow rules set by Medicare Medicare Part D (Medicare prescription drug coverage) Helps cover the cost of prescription drugs Run by Medicare-approved private insurance companies that follow rules set by Medicare May help lower your prescription drug costs and help protect against higher costs in the future Rick Teska. All Rights Reserved

4 What are medicare Supplement Insurance (Medigap) Policies? Click here to watch the video Medigap policies are standardized Every Medigap policy must follow federal and state laws designed to protect you, and they must be clearly identified as Medicare Supplement Insurance. Insurance companies can sell you only a standardized policy identified in most states by letters A through D, F through G, and K through N. All policies offer the same basic benefits so you can choose which one meets your needs. In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way Rick Teska. All Rights Reserved

5 WHAT S YOUR SITUATION? Turning 65 You must enroll into Medicare Part B within a 7 month window (3 months prior to and up to 3 months after your 65th birth month). You have up to 3 months after Part B goes effective to sign up for a Part C or Part D plan. Failure to enroll into Part B and D may trigger a penalty. You have up to 6 months after Part B goes effective to sign up for a Medicare Supplement Plan with no medical underwriting. On Medicare Now You can change your Medicare Supplement plan at anytime, once per month if you want. To change your Part C advantage Plan or Part D Drug Plan, you must have a Special Election Period (SEP) to do so, or you must wait for the Annual Enrollment Period (AEP) from October 15th to December 7th. Plan changes during AEP start on January 1st of the following year. Losing Insurance At Work IF YOU HAVE PART B ALREADY. You have 63 days from the day you lose work coverage to enroll into any type of Medicare plan. IF YOU DON T HAVE PART B. You can enroll at anytime while you re still working and you have up to 8 months after your work insurance ends to enroll into Parts A and/or B without penalty. Click here to watch the video Permanently Disabled (at any age) Once deemed Permanently Disabled, you will typically receive Medicare benefits starting in the 25th month. This varies by disability. Those with ALS receive Medicare benefits the same month your disability benefits begin. You do not need to be 65 or older to receive Medicare benefits when permanently disabled. Click here to watch the video Click our logo for more information Rick Teska. All Rights Reserved

6 Expert money & time saving tips Not Shopping Around Surprisingly, many clients never consider shopping around for the best priced Medigap plans. It s one of the biggest mistakes we see. Reviewing your coverage and shopping around once per year is the best money saving action you can take. Medicare supplement plans are standardized. Each letter A through N represents a specific set of benefits, these benefits are the same no matter which company sells the plan. In other words a plan F with Aetna is the same plan F with Blue Cross and Blue Shield. The only difference is cost. For example, in the state of Iowa a Plan F (most popular) with one company is $80.60 monthly that same Plan F with another company will cost you $ monthly. That s a huge difference in premium for exactly the same policy. (Published rates as of 5/30/2017) Buying directly from an insurance company A lot of money is spent by large insurance companies on advertising and the reason why is it works. It is the reason why companies like UnitedHealthCare and Aetna attract so many customers. Working with an independent advisor will allow you to look at lesser known companies that offer the same coverage but at a much lower rate simply because they are not spending your premium dollars on advertising. Enrolling Late For Part D Part D is the Prescription Drug Program (PDP). Since 2006, it has been a requirement that all Medicare recipients have creditable drug coverage. Without creditable coverage, you face a penalty of 1% of the national monthly PDP premium, for EACH MONTH you re not enrolled in a Medicare Part D plan, or lack creditable drug coverage elsewhere. Over time this can really add up and it never goes away. Not asking the right questions Which company s plans are you authorized to sell and what do I qualify for? How much will I have to pay for premiums, deductibles, doctor visits or hospital stays? Will my current doctors accept the coverage? Will I have to choose hospital and health care providers from a network? Will I need referrals to visit specialists? Is there a yearly limit on out-ofpocket costs? Will the plan cover me if I get sick while traveling in another state? What will my prescription drugs cost? Are my drugs on the plan s drug list (or formulary)? Does the plan include the pharmacies I currently use? What payment options does the plan offer to pay my premiums? When can I change plans if I don t like what I ve chosen? Rick Teska. All Rights Reserved

7 Expert money & time saving tips What s in a Brand Names Today s Medigap insurance market has over 50 different carriers selling the same Medicare standardized plans. Some carriers are better known than others. This is often because of advertising, participation in other markets or the sheer amount of their product offerings. The problem with brand names is that they often allow companies to charge more for their product. It s a proven fact that people are willing to pay more for a recognizable name. However, it s important to keep in mind that with Medicare supplements coverage is federally standardized. This means that the big name company has the same product as little guy on the corner. Working with an independent advisor is your best bet to reviewing all price points available in your area. The old if it s not broke don t fix it Click our logo for more information Co-Pays, Deductibles OH MY! Time and time again we talk to people that are faced with HUGE out of pocket costs because the plan chosen has copays and deductibles. Often these add up to large sums of money at the end of the year. People enroll in these because of the low premiums advertised but do not realize how quickly costs start to accumulate. Save yourself the headache and your wallet the expense. Enroll in coverage that protects you and saves you money such as a Medicare supplement. This old adage DOES NOT apply to the insurance market. We know that it can be easy to just file away your policy and forget about it. However annual reviews are crucial if you expect to save money. Don t ignore those annual rate increase letters. Insurance companies introduce new products in your state all the time. Your time is well spent when you sit down with an independent advisor annually Rick Teska. All Rights Reserved

8 MEDICARE Critical Dates & Deadlines IMPORTANT DATES TO KNOW Annual Enrollment Period (AEP) October 15th - December 7th The only reason for AEP is to allow those with a Medicare Part C or Medicare Part D plan to change those plans. It also allows those that don t have a plan, to finally enroll into a Part C or Part D plan. All applications made during AEP take effect on January 1st. Annual Disenrollment Period January 1st - February 14th During this period, you are allowed to drop your Medicare Advantage Plan (Part C) to enroll back into Original Medicare. You may also enroll into a Part D Prescription Drug Plan during this time. You can also enroll into a Supplement Plan, but since this is not considered a Guaranteed Issue period, your application will be fully underwritten and you can be denied coverage. HINT: Apply for the Supplement first, see if you are approved, then drop your Part C plan. This way, you won t be left without some type of coverage. Part B Enrollment Period January 1st - March 31st For anyone that missed an opportunity to enroll into Medicare Part B, this is the only time they can enroll. Enrolling during this time will give you Part B, but it will not take effect until July 1st of the same year. If you enroll late, be prepared to pay a 10% penalty over the current Part B premium for each 12 month period you did not have Part B, or some other type of creditable coverage. This enrollment period is not for people who had creditable coverage elsewhere, and may be losing or giving up those benefits. In your case, you would sign up for Part B under a Special Enrollment Period (SEP). See the SEP box below. Special Enrollment Period (SEP) Year Round - Time Frames Vary There are dozens of reasons that would trigger a special enrollment period for applying for Part B, or for changing or adding a Medicare Plan. The most common would be losing workplace health insurance. Call me to discuss your situation. See some of the other reasons to the right. Supplement Medigap Insurance Enrollment Year Round - Every Month Most don t realize that you can apply for a Medicare Supplement plan at anytime, there is no enrollment period. Even those with a plan can try to reduce their monthly premium by shopping around. We offer this service for free, but here s the catch: If you apply outside of a guaranteed issue period, your application will be reviewed by the underwriting department and you can be denied due to health history. We offer plans that DO NOT ask any questions about your current Medication usage, and have a 98% acceptance rate, so we can get you approved in most situations. SEP Examples: APPLYING FOR PART B - at anytime when you re covered at work (and over 65), within 8 months after you lose or voluntarily give up coverage at work, in the 25th month after being diagnosed as permanently disabled. CHANGING YOUR ADVANTAGE PART C or D PLANS - if you re on Medicare, during a long-term care stay longer than 90+ days, within 63 days of being discharged from a long-term care stay, within 63 days of moving from a different county as long as the same plan does not exist in the new county, if you re eligible for a Part D Low Income Subsidy (LIS) from the state, if your current plan ends their contract in your county or goes out of business, if your current plan lied or misled you, returning from living abroad Rick Teska. All Rights Reserved