3 Reasons Not to Ignore Medicare AEP

AEP (Annual Election Period) for Medicare Advantage and Part D Drug Plans starts on October 15 and ends on December 7. Even if you have no complaints about your current plan, there are three reasons why it is still a smart move to review your options.

  • Your Plan Benefits or Premium May Be Changing: Every year companies review the plans and often change the premium and the actual benefits. Prior to AEP, they will send you notification of changes but many people ignore the notice. For instance, your plan may add a Drug Deductible of $300 to upper tier drugs and you will suddenly find that out in January when you refill your prescription. Or, they may have changed the “per day” hospital copay from $250 to $400. With an average hospital stay of just over 2 days, that means your next inpatient visit will jump from $500 to $800. And, of course, all companies adjust their premiums so the plan that was the best value for you last year may not be this year.
  • Your Particular Needs May Have Changed: During the past year, your doctor may have added a new prescription. You may find that your plan has a higher copay on that drug than another plan might. The copay for Outpatient Surgery or Primary Care Office Visits may have increased. You may now have a need for hearing aids or glasses for which many plans have benefits included. Some plans have Dental Care either included or available as extra-cost options. Many plans also include gym memberships at no additional charge.
  • Networks May Have Changed: Often the choice of a plan revolves around whether your doctor or specialists are considered “in-network” or not. Companies are always trying to expand their networks. A plan that did not include your doctor last year may include him this year, which now makes that plan a viable choice for you.

There is absolutely nothing wrong with being happy with you plan and continuing with it for years to come. If you decide to do that, you don’t need to do anything as the plan will be automatically renewed (as long as it is still being offered in your area) and your premium will be adjusted to the new year prices. On the other hand, It just makes good sense to take a few minutes during AEP to review the options to make sure your plan is still the best choice for your particular needs. Agents usually have all the details about the new plans by October 1. If you don’t have a local agent, and you live in the North Idaho area, feel free to contact me for an appointment at your convenience.

Seniors and Mental Illness

Older man in cafeThe month of May is Mental Health Month so it is very appropriate that we talk about mental illness as it relates to seniors. The National Council on Aging (NCOA) reports that one in four older Americans will experience some form of mental illness so this is not some rare occurrence we are talking about. Contrary to some negative stereotypes, it is not a normal part of aging to feel lonelier or more unhappy as people get older.

In an article published on May 4, the NCOA discussed the two major areas of concern: anxiety and depression. No one should have to suffer under the assumption that nothing can be done or that help is not available. If you or someone you know exhibits symptoms of anxiety or depression, it is important to seek help immediately.

There are many symptoms and diagnoses for anxiety. It is important not to “self-diagnose” any illness, but some symptoms to be on the alert for are panic attacks, nightmares, phobias or chronic worry about everyday activities. The nonprofit organization Mental Health America (MHA) has developed a free, anonymous online screening tool for anxiety. To be clear, this is not the same as a medical diagnosis, but some may find it helpful to use the screening results to start a conversation with their own physician.

Depression can also take many forms. You may notice in yourself or others symptoms such as poor sleep, extended periods of sadness, loss of enjoyment in everyday activities or loss of energy. Many articles have been written about depression creating a greater risk for suicide, but depression can also lead to an overall lower quality of life and even to physical health problems. Here again, MHA has developed an online screening tool for depression that people may find helpful in determining to seek professional help.

For people over 65, Medicare helps cover a wide range of mental health services including tests and visits with a physician, psychiatrist or social worker. Part D coverage can also help cover the costs of many medications prescribed to treat mental illness.

Although the month of May is designated as a time for heightened awareness of mental illness in our country, we should always be on the alert for symptoms in ourselves and in those we love. The stigma of the words “mental illness” have often caused people to avoid even discussing the issue. Just as with any other health issue, you should never hesitate to discuss your concerns with your family or you personal physician.


Seniors and Traveling Abroad

Now that you’ve ditched that 9-5 job, you’ve pulled out the Bucket List and found foreign destinations on the agenda. Excellent! In addition to checking Expedia and those cruise line brochures. the US Department of State’s Bureau of Consular Affairs has a few tips for you. On their website they have an article appropriately titled “Considerations for Older Travelers“.

While I recommend taking the time to read the entire publication, here are some highlights to remember.

  • Travel Documents: Make sure they are all correct and up to date. Make sure your passport will be valid for 6 months beyond the end of your trip or some countries may not let you enter.
  • Sign up for the State Departments “Smart Traveler Enrollment Program” where your itinerary and contact information is stored securely. This allows the embassy or consulate to contact you in case of an emergency or a security situation.
  • The State Department reminds you that Medicare does not cover you out of the US and recommends that you obtain travel insurance. You can start on that project by visiting our Travel Insurance page right here on this website.
  • Medications: Be sure to take an adequate supply of your prescriptions and leave them in the original, labeled container to avoid problems at customs. Also, know the generic name for your drugs as the generic may be more likely known in a foreign country.
  • Financial: Be sure to know the currency of the countries you are visiting and whether you should convert prior to entering the country. Also, make sure your credit cards will be accepted where you are traveling. Finally, check the State Department’s “Country Information” page to learn about any ATM scams or other financial scams that might target US visitors.

You’ve probably spent years saving and planning for these trips so it only makes sense to be prepared. Do a little homework and plan on having the time of your life!

Will Trump Change Medicare?

As the Trump presidency looms ahead of us, it is important for those of us either on Medicare or soon to be to take a look at what the new administration may bring to Medicare. Although there are many possibilities, there are a couple of areas worth considering.

Republicans, and the President-Elect, have vowed to repeal the Affordable Care Act (ACA), also known as Obamacare. No one has yet offered a specific plan for replacing the program and there are differing opinions within the party whether to keep some of the ACA’s more popular provisions or throw the whole thing out. What does that have to do with Medicare? Plenty! Within the ACA are several provisions that directly impact the Medicare system. Despite the fact that candidate Trump campaigned on promises to keep Medicare intact, the fact is that the repeal of the ACA will severely damage Medicare.

The ACA included provisions that strengthen Medicare by reducing its costs and increasing its revenue. These include reducing Medicare payments to providers, increasing revenue with higher taxes on high income individuals, closing the “doughnut hole” in the Part D Drug Coverage and much more. For a more thorough discussion, see this article from the non-partisan Kaiser Family Foundation. The bottom line is that if all of these provisions are repealed along with the ACA, the Congressional Budget Office estimates the additional cost to the Medicare program over the next 10 years will be $802 Billion! Yes, BILLION!.

How will that additional cost impact Medicare Beneficiaries? Higher Part A and Part B deductibles, higher premiums on Part B, higher premiums for Medicare Advantage plans, higher out of pocket costs for medical services and more.

A second area of concern is that House Speaker Paul Ryan has long advocated for the privatization of Medicare. Until now, he has not had the support in Congress to push it through. But with a Republican controlled House, Senate and now the White House, things are different. Ryan indicated in a recent Fox News interview that he is now ready to move ahead with his plan. Ryan continues to justify his plan by stating that Obamacare is causing Medicare to go broke. That is at complete odds with the Congressional Budget Office that, as indicated above, has already determined that the repeal of the ACA will cost Medicare nearly a Trillion Dollars.

Under Ryan’s plan, a person on Medicare would receive a voucher for a certain amount and would apply the funds (premium support) toward a private insurance plan. Supposedly, those on Medicare currently could continue with the plan. There is some doubt however, about the future of traditional Medicare if that happened. With no more new people coming into the program, those in it would become older and sicker and the program would probably go broke quickly. So much for being “allowed” to stay on original Medicare!

It is important to understand the strategy of the incoming administration and to pay attention to all proposals submitted. If there is an attempt to gut Medicare, rest assured that it will be sugar coated and quite possibly tucked away inside some other legislation. It is important for every beneficiary who depends on Medicare to be alert and let your elected representatives know how you feel about Medicare. There are those who believe that if Ryan and others in the GOP have their way, Medicare as we know it could be gone by next Thanksgiving.

Introducing Idaho Senior Insurance

Medicare Insurance Products

I am pleased to be able to launch my new website, Facebook page, and Twitter feed for Idaho Senior Insurance products for Medicare beneficiaries. While the introduction of these new media sites marks a significant change in my insurance practice, it is important to note first what is not changing:

  • I still work for North Idaho Insurance, an office of Alliant Insurance Services, Inc.
  • North Idaho Insurance still offers a full spectrum of insurance products for Business, Commercial, Auto and Home needs. In fact, our agency just moved into more modern and spacious offices at 509 N 5th Ave Ste H, in Sandpoint and added another experienced agent to handle the growth of the agency.

So, what is changing?

  • I am now concentrating my personal practice on Senior Insurance products such as Medicare Supplements, Advantage and Drug plans, Final Expense plans and Dental and Vision plans.
  • I will continue to service all of our agency’s individual and group health and life clients as well.
  • By focusing on just one area of insurance, a pleasant side effect is that I will usually be able to work less than 5 days per week.

Over the years many of my clients have found the area of Senior Insurance products to be confusing and intimidating. Unfortunately I was unable to devote the time necessary to expand this part of the agency as long as I was also committed full-time to our Commercial and Personal Lines products as well.

Now, by concentrating solely on this area, I have been able to take on the additional companies and products needed to offer my clients the widest choice of plans and pricing available. In addition to companies I have long represented such as Blue Cross, Regence, Bridgespan and Delta, I have now taken on Senior Insurance industry leaders like Humana, Aetna, Security Life, PacificSource and Transamerica, among others.

So if you are a Senior (like me!) and need to review your coverage, or you happen to be approaching that landmark Medicare age of 65, be sure to phone me for an appointment at (208) 263-2194 or submit the Contact Form.

For over 30 years I have enjoyed helping people find solutions to their insurance needs and I look forward to continuing that process with this new area of specialization.

Medigap or Medicare Advantage – Which is Best?

Which is best, Advantage or Medigap?Folks on Medicare find out quickly that, as nice as it is to have Medicare, the program simply does not pay for everything. Most everyone faces a choice of selecting a private plan to make up some of the difference. The most common choices are either a Medicare Advantage Plan that includes Drugs, or a Medigap Plan combined with a separate Drug Plan. I often get the question, “Which is best?” As with so many such questions, the correct answer is that “It depends.”

The Medigap plans are more accurately called Medicare Supplement Plans and they come in several different options standardized by the federal government into “lettered” plans (Plan C, Plan F, etc). These plans have been around a long time and although each plan varies, they can pay some or all of your Part A (Inpatient) Deductible, Part B (Outpatient) Deductible, the other 20% of the Medicare approved amount for certain services, the balance left over when doctors charge in excess of the allowed amount, some coverage for out of the country needs and so forth. What is common about them is that they can be used with any doctor that accepts Medicare. So, no networks, no referrals, no having to choose a Primary Care Provider. Medigap Plans do not cover drugs so it is necessary to purchase a separate Part D Drug Plan (PDP) to cover that aspect of your health care.

Medicare Advantage Plans have been around in one form or another since the 1970’s. Rather than filling in the “gap” in what Medicare doesn’t pay, they actually replace Medicare for your coverage. They typically don’t have deductibles for inpatient or outpatient care but it is common for them to have co-pays for doctor visits, a certain number of days in the hospital and so on. Many are HMOs and some are PPOs, but what they generally have in common is a preferred network of doctors and providers. If you go out of network you either pay more or, in some cases, have no coverage at all. The exception is that emergency and urgent care is almost always covered at in-network pricing regardless of where you are when the incident happens. Medicare Advantage Plans generally have the option of including Drug coverage in the plan. Medicare Advantage Plans, by and large, cost less than a Medigap Plan combined with a separate Drug Plan.

People who travel a lot, perhaps spend months in Arizona or elsewhere, may find Medigap or Supplement Plans to be a better fit, despite the higher cost, because there are no network restrictions. For people who get their primary care near their home and might only need emergency care when occasionally traveling, may find a Medicare Advantage Plan more to their liking, but it is important to examine the network and make sure it works for you.

Finally, since Medigap plans tend to leave you with less to pay out of pocket for doctor visits and hospital stays, I also usually recommend that you carefully consider your own health history before purchasing either type of plan. If you visit the doctor often or have just a couple of hospital stays, the savings of the Medicare Advantage lower premiums can quickly disappear in multiple copays.

As with all such decisions, I recommend that you sit down with an insurance agent that specializes in this sort of coverage, or do some very careful research on your own. To set up an appointment with me, just phone or return the Contact Form. To research on your own, the best place to start is the official government website, Medicare.gov.

Ready for AEP?

medicare-wp-sizeAnnual Election Period starts October 15 and runs through December 7. This is the time when anyone with a Medicare Advantage plan or a Part D Drug plan can change to a different plan. Also, a person with a Medicare Advantage plan, also known as Part C Medicare, can decide to drop their plan and revert to original Medicare. If you do that, don’t forget that you will need to purchase a separate Part D Drug plan at that time.

Naturally, if you are happy with your current plan there is absolutely no reason to make a change. By now, you should have received your annual Notice of Changes for your plan for 2017. Don’t ignore this letter! You may find that not only the premium has changed but coverage may have changed as well. Perhaps last year your plan had no Drug Deductible and for 2017 it will have a deductible. Don’t wait until you fill your first prescription in January and be surprised.

It is easy to compare plans. You can do it yourself by going to the official Medicare website and take a few simple steps. If you are not comfortable with a computer or just prefer some face-to-face help, call an insurance agent that specializes in Over 65 products. Make sure the agent represents several companies so you won’t be getting information on only one plan.

Also, don’t be swayed to automatically purchase a plan just because you see it advertised on television all the time. While those plans may be just fine, their premiums vary from state to state and even county to county. And never forget, television advertising is expensive and the cost of marketing obviously has to be included in the premium.

The main thing is, time is short! The Annual Election Period ends on December 7 and if you hesitate you may be stuck with a plan you don’t like for another year. So go online or call an agent today to get started.