Tag: medigap

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.

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.

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.

Medicare Part B and COBRA

Over the years we have found there is a lot of confusion concerning Medicare Part B and COBRA. Many people think that as long as they have COBRA, they don’t need Medicare Part B. Unfortunately, the special rule for delaying Part B is based on current employment(either you or your spouse). COBRA is not considered current employment coverage. Most people are able to delay enrolling in Part B, as long as they are still working. Once the employment ends, however, the clock starts ticking. You will have 8 months to sign up for Part B without a penalty. If you wait for COBRA to end, or go past the 8 months, you can be subject to a penalty of 10% of your Part B premium for each year that you were not enrolled. And that penalty stays with you as long as you have Medicare. Even more important, if you miss that deadline, you would have to wait until the next General Enrollment Period(from January 1st until March 31st each year), and your Part B coverage wouldn’t start until July 1st. This could have devastating consequences if a serious illness were to strike during that time. Another important thing to remember is that your Medigap Open Enrollment Period begins when you are both 65 and enrolled in Part B. This is a one time opportunity to purchase a Medicare Supplement policy, regardless of your health conditions. Some people go back to work, or get on a spouse’s current employment coverage, after enrolling in Part B. At this time, you may be able to disenroll from Part B, and enroll at a later time(such as when that employment ends), without a penalty. This can sometimes be a good strategy, but it is important to remember that your Medigap Open Enrollment doesn’t re-start. With more people working longer, delaying Social Security, or Part B, it more important now than ever to have good advice on your Medicare choices and deadlines. Please call at 877-740-8683, for a personal review of your situation.

Medigap Plan F for Convenience

While we as an agency have been gravitating toward Plan G for our Medicare Supplement (or Medigap) customers, there is still a strong case to be made for the Plan F. For years the Plan F has been the most popular choice among seniors, for good reason. With Original Medicare and a Plan F Medicare Supplement, you have virtually no out-of-pocket costs for Medicare Services. There are no deductibles, no co-pays, and no co-insurance. It is a great feeling to know you can go to the doctor and walk out without paying a cent. You don’t even have to ask if the doctor accepts Assignment. As long as he accepts Medicare, you are good to go. There are also times that a Plan F Medigap policy is the best choice for a Guaranteed Issue situation. If you are the kind of person that really likes convenience, the Plan F may be the way to. To find out if you have the best price for your current Medicare Supplement, please give us a call at 877-740-8683, or visit www.emedigap411.com , for a no obligation comparison.

Update on Universal Health Care Plan Termination in TX

We published an article last month, Medigap Guaranteed Issue-Plan Termination, that had valuable information for anyone who was affected by the Universal Health Care plan terminations in FL, and several other states. At the time, the Universal Health Care HMO plans in TX and NV were not included in the plan termination. Since then those entities have terminated their contract with the Centers for Medicare and Medicaid Services(CMS), by “mutual consent”. In addition, the Texas HMO has also been placed in receivership. The members that were enrolled in these plans lost their coverage on 5-1-2013, and were returned to Original Medicare. The good news for these members is that they will have a Special Enrollment Period until June 30th 2013. During this time, they will be able to choose a new Medicare Advantage plan that is available in their service area. More importantly, this will trigger a Guaranteed Issue opportunity for these members to purchase a Medicare Supplement, also known as a Medigap policy, without having to answer any health questions. A lot of these people have had health conditions that would have made them unable to purchase a Medigap policy in the past, so it is very important to know the options, and deadlines, so they don’t miss this opportunity. If you or someone you know has been affected by any of these plan terminations, Please call 877-740-8683, or visit www.emedigap411.com for more information.

 

Reminder: Anyone that was involved in the earlier plan termination on 4-1-2013, will have a deadline of May 31st 2013.

Medicare Disability Medigap Policy

Many people who are under 65 and on Medicare Disability are unaware that they could be eligible for a Medicare Supplement, or Medigap, policy. That has meant that a lot of people on Medicare Disability have thought their only option was a Medicare Advantage Plan. While not all states have requirements that Insurers offer under 65 Medicare Supplements, if your state has these requirements, it can be a great option. The people we have found that benefit the most from having an under 65 Medigap policy are those that have higher out-patient costs. Even a Plan A Medigap policy(which is often the only choice under 65) will pay the 20% Part B co-insurance. This can be a life saver for people that have high Part B drug costs. It is also important to know that if your state does have under 65 requirements, you have many of the same Medigap protections, such as Open Enrollment within 6 months of Part B effective date, Guaranteed Issue if your plan terminates, etc. To find out if your state has under 65 requirements, and find the best price in your area, call 877-740-8683, or visit www.emedigap411.com