Retiring Baby Boomers Healthcare

Retiring Baby Boomers healthcare costs are a big concern and need to be planned for … starting now!

When you think of retirement, you think of white sand beaches, or sipping coffee on the porch, or riding your Harley till you find that quaint little town and stop and the night … basically you leave the bump and grind and being your stress-free life, right? Retiring baby boomers are not thinking of having to deal with the complicated world of Medicare or your retirement health insurance. Yuck!

So for those of you who like to look through the “rose-colored glasses”, we have listed a few key things about healthcare costs that retiring baby boomers should be aware of so you can prepare now as retirement nears.

Medicare isn’t FREE.

Shocker? Most retiring baby boomers assume that all of a sudden once they stop working and get on Medicare, magically all of their medical bills will be paid. It’s probably because we all paid so much in for so many years, it would seem justified, however it isn’t the case. How it really works is Medicare Part A covers things in hospital and that part is FREE for most enrollees. Then Medicare Part B, which covers outpatient services and Medicare Part D, which is the prescription part, isn’t FREE. To add to it, all of the parts of Medicare come with varying deductibles and other out of pocket costs that can add up, not to mention it doesn’t have an annual out-of-pocket limit like most of us are used to with our health plans.

A typical retiring baby boomers healthcare costs will look something like this once enrolled in Medicare:

Part B premium, which for most people is $104.90 as of 2016, but those with higher incomes are subject to higher premiums.
Medicare Part A Deductible- $1,288 per benefit period (for 2016). Now Medicare says a “benefit period” is the day your’re admitted to a hospital or skilled nursing facility up until you reach the point where you haven’t received inpatient care for 60 days in a row. So basically, in a year you could pay that $1,288 deductible multiple times … there’s no limit to the number of “benefit periods” under Medicare Part A. Plus, you are charged for each day you are confined, and there is no limit on that either.
Medicare Part B Deductible – $166 per year (for 2016).

So to boil it all down, when you are enrolled in Medicare alone, you will spend thousands of dollars each year out-of-pocket. In fact, in 2010, according to the Kaiser Family Foundation, Medicare beneficiaries spent an average of $4,745 on out-of-pocket healthcare expenses. That doesn’t sound FREE to me!

Retiring baby boomers need supplemental insurance.

Generally, Medicare will cover about 80% of the medical expenses, which is why most people use supplement insurance plans to cover the other 20%. There are a lot of different Supplement Plans or Medigap plans available. They are sold by individual carriers and vary by price and benefits. Some do really good at picking up what Medicare doesn’t pay, and others have more out-of-pocket costs to you. A Medigap plan with very little out-of-pocket cost will probably average you around $180 per month.

Now as we said, Medicare doesn’t cover everything, and may not meet all your retirement needs. Just as Medicare doesn’t cover funeral expenses, it also doesn’t cover the cost of nursing home care or assisted living facilities, therefore you have long-term care insurance. Key is, the best time to buy is when you are young and healthy, just like your life insurance. The average 60-year-old couple pays about $3,400 per year in premium costs, but having a plan could save you and your loved ones thousands upon thousands in the long run. The American Association for Long-Term Care Insurance reports that more than 50% of applicants aged 50 to 59 qualify for long-term discounts based on their health, but that figure drops to 42% among 60- to 69-year-olds and 24% for 70- to 79-year-olds. The facts show the older we get the less likely we are to qualify, so if you are interested in seeing about long-term care insurance, click here for a free quote.

“I’m not going to be 65 when I retire, what do I do for health insurance?”

So let’s say you are one of the “lucky” ones and will stop working before you get Medicare eligible, you will have to get health insurance on your own until you reach 65. There are a few ways this can happen:

JOB: If you had health insurance with your employer, you may can continue your coverage under that same plan, that is called COBRA, which allows you to keep the plan for up to 18 months. If you elect COBRA, you will pay the full cost of your plan, whereas your employer most likely paid some of it. Most COBRA premiums are high, but before you make the choice, you need to shop around, you generally have 60 days to elect it.

INDIVIDUAL: If you didn’t have the option of COBRA, or you have exhausted your COBRA already but you still aren’t 65, you have the option of shopping individual plans. Now days, everyone is talking about Obamacare, and on and off the exchange. That is a whole other post you need to read … basically know it is available but keep in mind that the (2016) prices have gone up from when you shopped last, and plans have changed. You may have to take a higher deductible or a plan with fewer copayments, but the main thing to look at is network. Most carriers are only offering HMOs, so you must stay with a doctor in network – so make sure your doctor is in that network on the plan you choose, or you will have to change doctors. Keep in mind, if you get a plan that is not ACA qualified, you will be subject to the penalty when you pay your taxes.

Good news!

Typically we see most retiring baby boomers are happier with the healthcare costs once they get on Medicare vs what they are paying on their individual plans. However, once you retire, you’ll be on a fixed income, so the more you prepare now, either by putting back extra savings, or paying off more of your other liabilities, the better off you’ll be.

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.

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.

Medicare Supplement Plan F or Plan G

“That is the real question, which Medicare Supplement Plan do I go with?” Bob said. “Plan F or Plan G? They both look the same.” “Good question.” I told him. Then I began to explain as I do to all the folks I talk to who ask this same question. It’s funny how in the end, they always seem to agree and make the same decision because it just makes $ense.

Here is the deal. Plan F has been the most popular plan in the Medicare Supplement Market for years. Mainly because it is simple to understand; most people have almost no out of pocket costs other than what they pay each month for the plan. If Medicare pays, then the Medicare Supplement pays. Some people even say the “F” stands for “Full coverage”. However, “Full coverage” as we all know, comes at a price, and sometimes it isn’t the best “bang for your buck”.

Plan F and Plan G are identical, the ONLY difference is, on Plan G you have to pay for the Medicare Part B deductible. Therefore, Plan G is becoming more and more popular, mainly because of the cost. If you look at the graph below, the Part B deductible has not changed in the past 3 years.

PART B DEDUCTIBLE HISTORY

In 2010 Part B deductible was $155
In 2011 Part B deductible was $162
In 2012 Part B deductible was $140
In 2013 Part B deductible was $147
In 2014 Part B deductible was $147
In 2015 Part B deductible was $147

Even though the Part B deductible hasn’t changed much in the past 5 years (in fact it’s lower than it was in 2011), Plan F prices have steadily been increasing every year. Basically, for 4 years people with Plan F have been paying more for a benefit that hasn’t changed.

When you look at the actual numbers, the Medicare Part B deductible breaks down to around $12 per month ($147 / 12 months). So if a Plan F costs $12 more than a Plan G per month for you, then you are paying too much!!! Make $ense??

In some areas, we see a Plan F for a customer and a Plan G be as much as $40 difference! So tell me, if Progressive or Geico told you that you could save $480 per year in premium and only add $147 in your deductible, would you be willing to make that change? Of course you would, because it makes $ense.

So after quoting Bob Plan F @ $187.39 per month and Plan G @ $157.35 per month … I said to Bob … “I always give folks the choice by showing them the price difference and let them make the decision … which plan do YOU think you should go with?” Without hesitation Bob blurted “Well I would be dumb to not go with Plan G!” Bob is a smart man. Over 90% of our customers go with Plan G, however if you are willing to give an insurance company $200-$400 in trade for $147, then we won’t mind helping you do that.

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.

What is a Supplemental Accident Policy?

MILLIONS of people have accidents every year.

Rate of Nonfatal, Medically Consulted Fall Injury Episodes, by Age Group

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

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.

Medicare Disability-Turning 65

We recently wrote about Medigap Policies for people on Medicare Disability. While some states have under 65 requirements, it is important to remember that each person, regardless of where they live, will have a new Open Enrollment Period the first month that they are both 65 and older, and on Medicare Part B. For people that were unable to get a Medicare Supplement when they were on Medicare Disability, this is a unique opportunity. Perhaps even more important, is the chance for people that had a Medigap Policy under 65 to get a fresh start. When people are fortunate enough to have a Medigap Policy while they are on Disability, the premiums are generally much higher than they would be for someone over age 65, and the plan choices are often limited to Plan A only. While the Plan A can be a good value for many people on Medicare Disability, a Plan F or Plan G provides many more benefits. We were recently able to help one of our current Plan A customers obtain a Plan G, when they turned 65. While their Plan A policy had gone down in price at their 65th birthday, they were able to get the much better Plan G, for about the same price, without having to answer any Health Questions. If you or someone you know has been on Medicare Disability, please call 877-740-8683, or visit www.freedomfreequote.com , for more information on this important time period.

Texas Universal Health Care Plan Termination-Deadline

As previously published, Universal Health Care plans in Texas terminated 5-1-2013. For those members that were enrolled in one of these plans, there is an important deadline approaching. These members have until 6-30-2013, to have a Special Election Period to enroll in another Medicare Advantage plan, or have a Guranteed Issue opportunity to purchase a Medicare Supplement, or Medigap plan. If you or someone you know was enrolled in one of these plans, please call 877-740-8683, to discuss your options before the deadline.

Texas Long Term Care

Many people are unaware of the need for Long Term Care Insurance. Nearly 70% of people over age 65 will need some type of Long Term Care, and the cost of care can reach $70,000 per year. To watch a quick overview, click the Own Your Future Video. While the traditional image of Long Term Care is a Nursing Home, today more people are receiving Home Health Care or even residing in an Assisted Living Facility. If you think Long Term Care is covered by Medicare even with a Medigap plan, Disability, or Health Insurance, you need to take another look. While Medicaid does cover Long Term Care, you have to qualify. Long Term Care Insurance is the one type of coverage designed to pay for Long Term Care. One of the more recent changes in Long Term Care Insurance has been the addition of Texas Long Term Care Partnership-qualified plans. If you own a Partnership Qualified plan, you can have a dollar for dollar offset in asset protection. For example, if you receive $50,000 in benefits under a Partnership Quailifed plan, you could set aside $50,000 in protected resources if you did have to later receive benefits from Medicaid. While the subject of Long Term Care is not always easy, the time to purchase is while you are still young enough to qualify, and receive a reasonable rate. To find out more about Long Term Care Insurance, and Partnership qualified plans, call 877-740-8683, or visit www.freedomfreequote.com , to request a free Long Term Care Planning Kit.