Category: Medicare

Fast and Easy 2018 Part D Breakdown

Is Medicare Part D confusing? Want a fast and easy 2018 Part D breakdown … Well look no further, we can help.

2018 Medicare Part D Breakdown

All Part D Medicare drug plans work the same as far as their coverage levels, they just offer different copayments and/or deductibles.

Deductible

If your plan has a deductible, you pay the total cost of your drugs until you reach your deductible set by your plan … then you move on to the initial coverage level.

Initial Coverage Level – $3,750

During the initial coverage level you pay your copay amounts set by your plan until your total drug cost reaches $3,750. The total drug costs is the amount “you and the insurance company” pay. Then you move to the coverage gap level, or “donut hole”

Coverage Gap Level / “Donut Hole” – $5,000

During the coverage gap level, you pay either a higher copay amount, or discounts until you pay a total in out of pocket expenses of 5,000. Out of pocket expenses is just the amount “you” pay. Then you move to the catastrophic coverage level.

Catastophic Coverage Level – Unlimited

The catastrophic coverage level is where you will pay generally the least copay amount until the end of the year at which time the plan will renew.

This fast and easy 2018 Part D breakdown is not company specific. If you need a specific quote for your Medicare 2018 drug plan click here.

Only some drugs are covered under part B of Medicare, but most drugs are not. You want to make sure that you get a separate drug plan when you become “eligible” for Medicare Part D, in order to avoid the future penalty.

2016 Changes to Medicare

The 2016 Changes to Medicare were found throughout the parts of Medicare.  Since most people do not pay a Part A premium, that change is kind of irrelevant.  There were some changes to what you pay under Part A deductible and coinsurance but none as noteworthy as the Part B changes.  The Part B deductible and Part B premium both changed in 2016.  View the chart below to see the exact differences.

2016-changes-to-medicare

Please note … The standard Part B premium amount if you enroll after 2016 is $121.80 (or higher depending on your income).  However, most people who get Social Security benefits will continue to pay the same Part B premium amount as they paid in 2015. This is because there wasn’t a cost-of-living increase for 2016 Social Security benefits.

You’ll pay a different Part B premium amount if:

You enroll in Part B for the first time in 2016.
You don’t get Social Security benefits.
You’re directly billed for your Part B premiums.
You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $121.80.)
Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount.

How will the 2016 Changes to Medicare effect me?

The 2016 changes to Medicare may effect each person differently.  If you only have Original Medicare, then your overall out-of-pocket costs will be greater.  If you have a Plan F, you may see your actual supplement premium increased.  If you have a Plan C, G, or any other plan that didn’t pay the Part B deductible …  your premium may not have increased as much, but you will notice when you go to the doctor you will pay a little more the first of the year over what you paid last year.   If you have Part C, or a Medicare Advantage Plan, then you may see changes when the plan renews for next year.  Regardless of the specifics, the 2016 changes to Medicare will have some effect on everyone who is on Medicare currently or who will be enrolling.

Need more information?

If you would like to shop for Medicare Supplemental Plans or need help with Medicare give us a call, we will be happy to help 877-740-8683 or locally 936-756-6199.

2016 Medicare Open Enrollment

Most people don’t realize that the 2016 Medicare Open Enrollment Dates only apply to people who are wanting to make changes to their Medicare Advantage (Part C of Medicare) and prescription drug plan (Part D of Medicare). Each year, open enrollment runs from October 15 to December 7. Therefore in 2016 it will begin on October 15, 2015. That is the time for you to shop around for a new Medicare Advantage Plan (Part C of Medicare) or a new Prescription Drug plan (Part D of Medicare).

So first of, to be clear, as far as enrolling in Medicare, you can do that as soon as you are eligible … no matter what month it is. Most people become eligible when they turn 65, and begin enrolling in Part B up to 3 months before their 65th birthday month.

It is only during open enrollment that you can switch from original Medicare to Medicare Advantage (Part C of Medicare), or vice versa. Also, if you find that another Medicare Advantage plan (Part C of Medicare) will fit your needs, or has a broader network, you can switch from one Medicare Advantage plan (Part C of Medicare) to another. Same with a prescription drug plan (Medicare Part D), you can switch from one plan to another during open enrollment or drop your prescription drug plan (Medicare Part D) coverage altogether. However, you may incur penalties later on if you go without a prescription drug plan (Part D of Medicare) – we would not advise this. Especially since you can get prescription drug plans (Part D of Medicare) for generally under $20 a month.

Now for people who are on a Medicare Advantage plan (Part C of Medicare), who miss the open enrollment but who just want to go back to original Medicare, there is also a Medicare Advantage disenrollment period (MADP) that runs from January 1 to February 14 each year. At that time, you could opt to switch back to original Medicare and then sign up for a prescription only plan (Medicare Part D). Most people will do this if they are going from a Medicare Advantage Plan (Part C of Medicare) to a Medicare Supplement Plan.

For 2015 coverage, open enrollment is over for Medicare. Medicare Advantage (Part C of Medicare) and prescription drug plans (Medicare Part D) ended on December 7, 2014, and the Medicare Advantage disenrollment period ended on February 14, 2015. Remember, you can enroll year-round in Medicare if you are newly-eligible.

For more information or to shop plans, visit us at www.emedigap411.com  call 877-740-8683 or email.

Medigap Continues to Grow

Recent studies shoe that Medicare Supplement, or Medigap, policies continue to grow in popularity. With over 10.5 million people enrolled in Medigap as of 12-31-2013, that represents a 3.8% growth over the previous year. People are also overwhelmingly satisfied with their Medigap coverage. 94% are satisfied with their coverage, 95% consider it a good value, and more than 9 out of 10 would recommend Medigap to their friends and family. You just don’t see that level of satisfaction with under 65 Health Insurance. Plan F continues to be the most popular choice, with 52% of plans purchased. Plan G, our pick for best value, and Plan N are growing in market share. One of the only complaints a person can have with Medigap is the price. While rates do go up, you are always able to change to a new Medigap policy at any time. Medigap policies are not subject to the lock in period that Medicare Advantage has. If you are turning 65, or new to Medicare, give us a call at 877-740-8683, and we will help you find the best rate. If you have a current plan, and would like to make sure you have the lowest price, you can also call, or visit www.emedigap411.com , for a free personalized price comparison.

I have Medicare, do I need to go to healthcare.gov?

All of our customers on Medicare Part A & B (or C) and possibly D are asking … “How is all this Obamacare gonna affect me?”

Well, no need to worry, you don’t need to do anything to your Medicare plan because it isn’t part of the healthcare.gov site.  If you have Medicare, you are basically already covered.

No matter how you get Medicare, whether through Original Medicare with a Medicare Supplement, or through a Medicare Advantage plan, (like an HMO or PPO) you don’t have to make any changes.

If you want to shop around for a Medicare Supplement plan or Medicare Advantage plan, you will not be able to shop rates on the Marketplace (healthcare.gov) … just give us a call and we can help you with that part or go to www.eMedigap411.com

If you only have Medicare Part B, most people do not know this, but you are not considered to have minimum essential coverage.  That means you would be subject to the penalty that people who don’t have coverage may have to pay.

If you only have Medicare Part A, you are considered covered, and of course if you have Part A and Part B you are covered.

One thing has changed and that is Medicare has expanded benefits for preventive care and drug coverage.   They now have free preventive benefits, cancer screenings, and annual wellness visits.  You can also save money while in the “donut hole” with discounts on brand-name prescriptions.  (No the donut hole is not a place to eat!  It is when your total drug costs reach a certain point while you are covered under a Medicare Part D Prescription drug plan.

If you are new to Medicare, here are some things to remember:
– Medicare’s Open Enrollment Period (October 15-December 7)
– To learn more about your Medicare options visit www.eMedigap411.com

If you have any family and friends who don’t have health insurance, or if they want to see what their subsidy amount might be, tell them to call us or visit www.healthreformenrollmentcenter.com

What is a Supplemental Critical Illness Policy?

Supplemental Critical Illness policy
Supplemental Critical Illness policy

Day-to-day life is complicated enough all on its own. So when you’re faced with the extra stress of a critical illness, the last thing you need to add on is financial worry.  Supplemental insurance helps protect you and … your family’s finances and future.

Critical Illness Insurance not only provides benefits to help with associated expenses, but it can also give you freedom to choose a better doctor, or get the best treatment available if your major medical plan doesn’t provide enough.  Do you …

KNOW THE RISKS

  • Men have nearly a 1-in-2 lifetime risk of developing cancer. 1
  • Women have a 1-in-3 lifetime risk.1
  • This year an estimated 770,000 Americans will have a new heart attack. 2
  • On average, every 40 seconds someone in the United States has a stroke. 3

KNOW THE COSTS

  • The total overall cost of cancer in 2007 was $219.2 billion. 4
  • The estimated direct and indirect 2008 cost of coronary heart disease is $156.4 billion. 5
  • The estimated direct and indirect cost of stroke for 2008 is $65.5 billion. 6

$219.2 BILLION

        40 %                                                                       60 %

      DIRECT                                                                 INDIRECT
MEDICAL                                                        OUT-OF-POCKET
COST                                                                       COST

    $89 Billion                                                                            $130.2 Billion

    DOCTOR &                                                             (HIS) LOSS OF INCOME
HOSPITAL BILLS                                                       (HER) LOSS OF INCOME
HOUSE PAYMENTS
CAR PAYMENTS
FOOD
GAS
ELECTRIC BILLS
TELEPHONE BILLS
OTHER LIVING EXPENSES
Not to mention …
TREATMENT COSTS
TRAVEL EXPENSES
MOTEL BILLS
COST OF EATING OUT

How would you pay for out-of-pocket expenses associated
with a critical illness?

If you are like many people, you have few options:

Spend your savings.
Sell your assets.
Buy supplemental insurance to protect your family, finances and future.


We believe you need more “CASH” for personal expenses rather than more INSURANCE for doctors and hospitals.

Your benefits are paid DIRECTLY to YOU ! ! !

Critical Illness Insurance includes these important assurances:

  • Your benefits are paid in addition to any other insurance you carry.
  • You cannot be singled out for a rate increase. Your rates can be increased only if they are increased for all plans of this kind in your state.
  • Your benefits are never reduced.
  • Your policy is guaranteed renewable for life as long as your premiums are paid when due – only you can cancel.

Click here for a quote on Critical Illness Protection 

 Frequently Asked Questions

Q: What is Supplemental Insurance?

A: Supplemental insurance is extra or additional insurance that helps you pay for out-of-pocket costs that your major medical insurance doesn’t cover. Things such as loss of income, co-pays and co-insurance, travel and lodging, etc. The benefits are paid in cash directly to you so you can use the money however you choose to pay for those unexpected expenses due to illness or injury.

Q: Do I really need supplemental insurance?

Unexpected accidents and illnesses happen. When they do, it can leave you and your family vulnerable to out-of-pocket expenses that major medical insurance does not cover. Supplemental insurance benefits give you piece of mind and reduce the worry about how you will pay for those unexpected expenses. With less worry, you can focus on getting well rather than how you will get the money to pay your light bill.

Q: What happens when I am diagnosed with a critical illness?

A: Filing a claim is easy. You will simply visit our web site to download your claim forms, or call us at 1-877-740-8683 to have them mailed to you.

Q: How can I get supplemental insurance?

A: We make it easy as 1-2-3. 1. Just call us toll-free at 1-877-740-8683. 2. We take the application over the phone in less than 10 minutes. 3. You get your policy in the mail in 1-2 weeks. It’s that easy! Our knowledgable representatives will work with you to identify your protection needs, so you have the coverage you need to help meet those needs.

Q: How do I qualify; do I have to complete a physical?

A: Most people do not have a problem qualifying for critical illness insurance, some cases you can even qualify if you cannot get major medical. There are a few health questions, and no physical is required. Generally, as long as you can answer “No” to the health questions, the coverage is issued and can become effective within 15 days from the date of the application.

Q: What services are covered?

A: Most plans pay cash for things such as:

Lump Sum benefits upon initial diagnosis.
Admission to a hospital
Family lodging for a member of the immediate family
Others

Q: What is generally not covered on a critical illness plan?

A: Most plans will not pay benefits for the following:

Loss diagnosed or caused by another disease or sickness withing the waiting period (waiting periods vary by state)
Loss due to participating in an illegal act or working at an illegal job
Loss due to being intoxicated or under the influence of any illegal drugs or narcotics, prescribed or not
Loss due to self-inflicted injury, or while attempting to commit suicide
Loss due to war, participation in sporting events.

Exclusions and limitations vary by policies by state, so always refer to your policy or outline for applicable exclusions and limitations.

View other supplemental coverages:

Accident
Heart Disease / Heart Attack / Stroke
Cancer
Hospital Indemnity

 

Facts provided by:
1 American Cancer Society, Cancer Facts & Figures 2008, 2008, p.1.
2 American Heart Association/American Stroke Association, Heart Disease and Stroke Statistics, 2008 Update (At-a-Glance Version), p.12.
3 Ibid, p.15.
4 American Cancer Society, Cancer Facts & Figures 2008, 2008, p.3.
5 American Heart Association/American Stroke Association, Heart Disease and Stroke Statistics, 2008 Update (At-a-Glance Version), p.14.
6 Ibid, p.17.

The above facts represent the U.S. population, are for information only and do not imply coverage under the policy or endorsement of the company or the policy by the people and organizations above.

What is a Supplemental Accident Policy?

MILLIONS of people have accidents every year.

Rate of Nonfatal, Medically Consulted Fall Injury Episodes, by Age Group
Graphic source: MMWR Quickstats, 02/03/2012
In 2010, the overall rate of nonfatal fall injury episodes for which a health-care professional was contacted was 43 per 1,000 population. Persons aged ≥75 years had the highest rate (115).
Will you or your family be affected?

Accidents and disabilities can create serious financial worries. A supplemental accident plan can help protect you and your loved ones from those concerns by providing additional assurance that major medical plans can’t.

In addition to the routine expenses that medical insurance covers, there are additional costs that you must pay yourself – not to mention the possibility of lost wages.

Protect your most valuable asset . . . your income!

With a supplemental accident plan, you get these assurances:

  • Your benefits are paid directly to you or to whomever you choose, unless otherwise required.
  • Your benefits have no lifetime maximum limits, and are renewable as long as premiums are paid.*
  • Your benefits are paid regardless of any other insurance you carry.
  • Your rates cannot be increased unless all rates of that kind are raised in your state.

*Some disability benefits/rider may only be guaranteed renewable to the age of 70

Did You Know?

Worker’s compensation only covers injuries that occur on the job.

Major medical plans may cover only routine medical expenses for accidents or disability, leaving uncovered costs such as copays, transportation, physical therapy, emergency room and a host of other expenses for you to pay out of your own pocket.

Loss of income due to a disability can strip you of your wealth-and the lifestyle to which you’re accustomed.

An accident plan is a great supplement to a high-deductible health plan.

According to the National Safety Council

  • 66% of all accidents occur off-the-job.
  • More than 23.8 million injuries required medical attention in 2003.
  • In 2004, over 82% of all costs due to accidental injuries were non-medical costs and expenses.

How would YOU pay for unexpected costs?

  • Spend your savings
  • Sell off assets
  • Preserve your resources with supplemental accident insurance.
Resources:
National Safety Council, Injury Facts, 2005-2006 Edition, p2, p23
The above facts represent the U.S. population, are for information only and do not imply coverage under the policy or endorsement of the company or the policy by the cited sources

Click here for a quote on Supplemental Accident Insurance


Frequently Asked Questions

Q: What is Supplemental Insurance?

A: Supplemental insurance is extra or additional insurance that helps you pay for out-of-pocket costs that your major medical insurance doesn’t cover. Things such as loss of income, co-pays and co-insurance, travel and lodging, etc. The benefits are paid in cash directly to you so you can use the money however you choose to pay for those unexpected expenses due to illness or injury.

Q: Do I really need supplemental insurance?

Unexpected accidents and illnesses happen. When they do, it can leave you and your family vulnerable to out-of-pocket expenses that major medical insurance does not cover. Supplemental insurance benefits give you piece of mind and reduce the worry about how you will pay for those unexpected expenses. With less worry, you can focus on getting well rather than how you will get the money to pay your light bill.

Q: I am on Medicare, retired, or don’t have any income; can I still get accident insurance?

Of course!  Falls and broken hips are major concerns with people on Medicare.  As you can see by the chart above, our chances of a fall increase dramatically the older we get.  Eventhough you may have a plan that pays for the hospital and doctor bills, you may need extra money for someone to come help take care of you during that time. Supplemental insurance benefits give you piece of mind and reduce the worry about how you will pay for those unexpected expenses. With less worry, you can focus on getting well.  You don’t have to be employed to purchase an accident plan, however it will not pay in addition to Medicaid

Q: What happens when I have an accident?

A: Filing a claim is easy. You will simply visit our web site to download your claim forms, or call us at 1-877-740-8683 to have them mailed to you.

Q: How can I get supplemental insurance?

A: We make it easy as 1-2-3. 1. Just call us toll-free at 1-877-740-8683. 2. We take the application over the phone in less than 10 minutes. 3. You get your policy in the mail in 1-2 weeks. It’s that easy! Our knowledgable representatives will work with you to identify your protection needs, so you have the coverage you need to help meet those needs.

Q: How do I qualify; do I have to complete a physical?

A: Almost anyone can qualify for an accident policy even if they cannot get major medical. There are very few health questions, and no physical is required. Generally, as long as you can answer “No” to the health questions, the coverage is issued and can become effective within 15 days from the date of the application.

Q: What services are covered?

A: Most plans pay cash for things such as:

Admission to a hospital
Dislocations, fractures, eye injuries, broken teeth, paralysis, burns, lacerations, concussions, and others
Emergency transportation in an ambulance
Family lodging for a member of the immediate family
Emergency treatment in a hospital emergency room or even a physician’s office
Confinement in an intensive care unit
Physical therapy
Othes

Q: What is generally not covered on an accident plan?

A: Most plans will not pay benefits for the following:

Operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven.
Engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot-air ballooning.
Participating or attempting to participate in an illegal activity.
Intentionally causing a self-inflicted injury.
Having any sickness, illness or bodily infirmity.
Committing or trying to commit suicide, whether sane or insane.
Dental care or treatment due to accidental injury to natural teeth.
War or any act of war (whether declared or undeclared) or participating in a riot or felony.
Alcoholism or drug addiction.
Injury originating prior to the effective date of the policy.
Injury to a covered person while practicing or being a part of organized or competitive football or rodeo, sky diving, or scuba diving.

Exclusions and limitations vary by policies by state, so always refer to your policy or outline for applicable exclusions and limitations.

View other supplemental coverages:

Critical Illness
Heart Disease / Heart Attack / Stroke
Cancer
Hospital Indemnity

Health Insurance Customer Service

We recently helped one of our customers keep his Grandfathered Individual Health Insurance Policy. His family has done business with our company for years, and when he went out on his own, he kept a Policy with our company. He had recently changed bank accounts, and this caused his bank draft payment to be returned. As often happens with young adults, he had moved a couple of times, and his contact information hadn’t been updated. One of the services our agency provides is to track customer payments, and help notify the member if they get behind. When we saw that this policy was in a potential lapse situation, we were able to get in touch with the member through his family. Then we were able to help him make payment arrangements, to keep his policy active. This was important, because he would not have been able to purchase a new policy at even close to his current premium. While he would have been able to qualify for a new policy at a higher rate, we have helped many people keep coverage that they wouldn’t have been able to re-qualify for, due to pre-existing conditions. I can remember several cases where the customer was even in the hospital when the bills got behind. The fact that we actually care, and do our best to help each customer in any way we can, is one of the things that sets Freedom Benefit Solutions apart from the competition. If you need help with your Individual Health Insurance or Medicare Supplement, give us a call at 877-740-8683.

Who Decides Your Health Care … If You Can’t?

You can actually appoint a medical power of attorney for all your health care. Most estate planners say that this may be one of the most important documents they prepare for their clients.

We recommend that it be someone who is very familiar with you and how you would like to be cared for. Also someone who can be available within a few hours and is willing and able to make decisions, and sometimes difficult ones that possibly you have already discussed.

How it works is, through a health care power of attorney, you designate someone you trust as your health care proxy or sometimes called health care “agent”. This person has the authority to make important decisions about your health, combined with a living will, these advance directives can guide your family and the ones you love not to mention the health providers in making decisions on how to treat you in the event you are incapacitated.

Now don’t worry if you don’t have an estate planning attorney, ask your financial services advisor or CPA to refer you to one so that you can set up a power of attorney for your health care today.

This is one more step to peace of mind!

Email us today for a referral to an estate planning attorney in your area, we will be happy to help you find one.

Email:  info at fbsagency.com  or call 877-740-8683

Medigap Plan G for the Future

For years we have beleived that Plan F was “the choice” for a Medicare Supplement, or Medigap, plan. There have been several changes in recent years, though,  that have made the Plan G Medigap policy more attractive. When Modernized Medicare Supplement plans were introduced in June 2010, that made the coverage gap narrower between the Plan F and Plan G. Now, the only difference between the two plans is that with Plan G you are responsible for your Part B Deductible. In 2012, the Part B Deductible was $140, and in 2013 it is $147. It really makes sense to choose Plan G, if there is ever an annual price difference that is greater than the Part B Deductible. Another factor that is becoming more important is Guaranteed Issue. In a Guaranteed Issue situation, an unhealthy person, with pre-existing conditions, can purchase a Plan F Medicare Supplement, but would have to qualify for a Plan G. That means there are potentially more sick people, with higher claims, enrolled in the Plan F. That has caused many carriers to have steep rate increases for their Plan F policies, while keeping the Plan G premiums more stable. The Affordable Care Act also spawned a recent move to either impose cost sharing on plans that have 1st dollar coverage, like the Plan F, or to place a surcharge on these plans. While these changes haven’t happened yet, we have encouraged our current Plan F customers, to look at changing to a Plan G. If you have a current Plan F Medicare Supplement, and are in good health, you owe it to yourself to take a look at the Plan G. We consider it the wave of the future.

For more information, or a free, no obligation quote, please visit www.emedigap411.com , or call 877-740-8683, to speak to a licensed agent.