Do I Need an Insurance Agent?

Do I need an insurance agent to buy a Medicare supplement plan? How much extra will I pay to buy through a broker? Do insurance agents offer the same plans that I can get direct from a carrier? Don’t most insurance agents push the plans that pay them the highest commission? confused senior medicare

It doesn’t matter if you are turning 65 and going on Medicare for the first time or you have been in the Medicare system for a few years. Most people still don’t really understand how Medicare works and how it applies to them.

You have questions. We have answers.

Shopping for Medicare coverage? With more than 230 different Medicare supplement plans in Georgia, how do you find the one that is right for you? Click and compare rates and plans from GA Medigap quotes

Have you ever seen a Medigap rate report like this?

Everyone I talk to will get a report that is customized to reflect the plan or plans where they have an interest.

If the agent that is trying to SELL you on buying from him or her isn’t offering information like this, what else are they keeping from you?

 

Should I use an insurance agent when buying a Medicare supplement plan?

This question comes up from time to time but I suspect it is often considered but rarely asked. When it happens to me it usually comes in the form of “How much do you charge for your advice?”.

Perhaps I should consider it an affront, but I don’t. I do wonder if they ask their home and auto insurance agent same question. Similarly, when people go online do they ask them how much more they have to pay for buying a plan from an 800 number agent?

My response is always the same.

bob on fbMedicare supplement plans you buy through me are the exact same plan at the same rate as those you would buy direct from the carrier. The only difference is, when you buy from me you get the advantage of my 40 years of experience at no additional charge. When you have a question you can call or email.

When you call you get me or my voice mail. You will never hear “Press 1 for English”. You won’t be routed through a bunch of prompts. I return calls within 2 business days and often the same day. If I can’t answer your question I will tell you so and will get back to you within 24 hours with the answer you need.

Call a carrier and you talk to whoever answers the phone that day, if you get a live person. More often than not you get voice mail. You have no idea who will call you back or when. You don’t know if they have worked for the carrier for years or just started last week.

Did I mention you pay the same premium for the same plan when you buy from an insurance agent?

 

Where can I see all the Medigap plans?

You can’t.

Some of is because most agents don’t have a quote engine on their site where you can see Medicare rates instantly. Something like this.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

Even if you find a quote engine you will probably only see a few plans. That’s the way it is on my site. The people who designed and maintain the quote engine only have permission from a few carriers to illustrate their rates.

If you found a site with 230+ Medigap plans and up to 50 different carriers it would probably overwhelm you.

Insurance agents act as filters, showing you the good and bad and providing insight into not only current rates but carrier history.

 

Bill and Brenda went Medicare shopping

Last year Brenda visited my site a few times, reviewed available plans and rates, but was not available when I called. I left a message but never heard back.

I only call once. If I get voice mail, I leave a message. That’s it. I don’t bug people to death. I don’t chase them down.

Meanwhile Bill and Brenda received several automated emails from me. Each one had information about Medicare in general as well as specific information on Medigap, Medicare Advantage and Part D.happy couple

After a few weeks had gone by Bill emailed me. They were both turning 65 and going on Medicare in a few months and they wanted me to come to their home one evening to discuss options.

Only one problem.

I don’t make house calls and I rarely conduct business after normal office hours, but I did agree to call them at a designated time and day.

 

How Much Can You Really Save?

We talked for perhaps 40 minutes or so. I walked them through the Medicare process and answered all their questions. I agreed to send them information by email so they could study their options in their time frame.

Brenda had already discussed Medicare with her friends and was convinced they needed to buy plan F from AARP/United Healthcare. If they needed plan F they could save $500 per year with a different carrier but the real savings would come by switching to plan G and save over $1000 per year.

The savings didn’t stop there.

Brenda was taking a “prescription” dose of Niacin as part of her cholesterol medication regiment. When I ran their drug report it turns out she was prescribed an OTC version. Her pharmacist was pulling the medication off the shelf, slapping a label on it and charging over $100 per fill for a 30 day supply. She was paying over $1200 per year on her high deductible plan.

I looked on Amazon for the same strength, slow release Niacin.

$17 for 175 tablets.

She could get a years supply for around $35 vs. $1200 from her druggist.

I suggested she ask her doc about the OTC version from Amazon. She did and he blessed the change.

She changed drug stores shortly after that. Probably should have changed docs too but that was up to her.

The point of this is, a few phone calls and emails with an insurance agent (that would be me) resulted in a savings of over $2,000 per year by using an agent. Had she followed the advice of her friends that decision would have cost her a lot of money over the next few years.

 

Do you need an insurance agent?

Not really.

Anyone can do this but very few insurance agents take the time to educate their clients the way I do.

In September of this year I will be going on Medicare and I am pretty sure I will take my own advice. The same advice I give others.

You need adequate coverage to protect you against the cost of health CARE.

You don’t need to spend all your money on insurance.

You don’t need as much coverage as you think you do and can certainly do better than buying what your friends have. Unless they bought it through Georgia Medicare Plans.

Shop and compare now.

Your information is NEVER sold.

 

 

#MedicareSupplementInsurance #InsuranceAgent #GAMedigapQuotes

Doctors That Take Medicare

Do all doctors take Medicare? The answer may surprise you. Which Medicare plans are widely accepted by Georgia doctors? Can my doctor refuse to take my Medicare plan? What happens then? How do I find physicians that take Medicare?

The I-Team investigates

Undercover investigation by ABC affiliate channel 11 in North Carolina discovers many medical practitioners are not taking new Medicare patients. At least part of the reason is low reimbursement by the government for treating Medicare patients. Cuts in Medicare funding brought about by Obamacare leaves many physicians wondering if they can afford to keep treating retirees over age 65.

The investigation discovered that 50% of physicians in the Raleigh-Durham area were not accepting Medicare patients

 

Do all Georgia Doctors take Medicare?

The short answer is no. A better answer is, most doctors DO accept Medicare patients. But many Georgia medical practices are not currently taking new Medicare patients or may have a waiting list for new patients.

Your challenge is even more diverse when you break it down by:

  • Doctors that take Medicare patients
  • Physicians that accept Medicare assignment
  • Doctors that do not participate in Medicare
  • Medical practices that participate in Medicare but not Medicare Advantage

medicare doctorThe good news is, most doctors participate in Medicare and do treat Medicare patients. About 96% of physicians that do take Medicare also accept assignment of benefits. Doctors that may opt out of Medicare are usually in the mental health field and some chiropractic doctors.

In Georgia about half the physicians accept Medicare Advantage patients and most of them will only participate in a few plans but not all. The number dwindles down further when you have an Advantage HMO plan.

Doctors can refuse to accept your Medicare Advantage plan if they are not in network. If that happens they are still required to file with original Medicare and then wait on Medicare to pay you. In these situations they are allowed to bill excess charges.

If you have an Advantage plan make sure you understand the rules and how your liability is determined.

 

Medicare participation

Finding physicians that participate in Medicare is relatively easy. If you Google “doctors that take Medicare” you will find an array of choices including other search engines and referral services. My advice is to go direct to the source, Medicare.gov.doc not taking Medicare

The Medicare physician finder is a useful tool for finding doctors, hospitals, DME suppliers and other medical facilities in your area that participate in original Medicare.

When you just use Google you will find doctors that

  • advertise locally on Google
  • are registered with referral services
  • are listed on Medicare plan sites
  • may be reviewed by Yelp or Angies List

While some of those sites may be useful the Medicare physician finder tool has been the most helpful for my clients.

Medicare supplement plans can be quite affordable and do not require network participation.

Your information is NEVER sold

New to Georgia

Jean moved from California to Georgia a few months before turning 65. She was covered by Kaiser in California but her plan offered only limited coverage in Georgia where she was considered a “visitor”. Jean had some medical conditions that required a specialist and she wanted freedom of choice when it comes to finding a doctor.

This meant saying no to Medicare Advantage plans with their limited doctor choice, high out of pocket and yearly changes in benefits.

Living on a fixed income, the one thing Jean needed most was a way to budget for her care. Original Medicare and a Medigap Medicare supplement plan F ratesplan was exactly what she needed.

When Jean contact me she was living with local relatives and didn’t want a bunch of insurance sales people coming to see her. At Georgia Medicare Plans we believe in personal consultation in the privacy of your home. We know that many people do not feel comfortable having strangers in their home and several do not want to travel to see us. Our focus is 100% client centered and we believe in respecting your “space”. That is why all of our clients receive information and advice by phone and email. There is never any pressure to make a decision and you move forward based on your time frame once you are comfortable you understand the Medicare system and can afford the coverage you want.

We spent several hours on the phone discussing her needs and looking at options. We emailed Jean information based on the benefits she needed and plans that fit her budget. We also provided her with details on Medicare Extra Help, a service that can reduce her out of pocket expenses for medication.

After reviewing all her options Jean selected Medicare supplement plan N from a carrier with a long history in covering Medicare clients. While most agents that talked with Jean pushed Medigap plan F she knew that plan was not going to fit her budget.

Blue Cross wanted $176 for plan F and United Health Care (AARP) even more at $180. The lowest premium she was quoted for plan F was $141 from Continental (Aetna) but that was still too much.

We talked about the differences in plan F, G and N and how each plan was more affordable due to cost sharing. Plan N coverer her Medicare Part A expenses at 100% but does require her to pay the Part B annual deductible + a $20 copay for doctor visits.

Jean’s premium for plan N was $86 from New Era insurance company. Even with the cost sharing she still cut her premium in half vs. most of the plan F plans.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

Finding a Medicare physician

As mentioned above, the Medicare physician finder is the most reliable tool in your arsenal for finding doctors in your area. Once you find some doctors that fit your needs, make some phone calls.

Here is what you need to know.

  • Does the doctor participate in Medicare?
  • Are they taking new patients?
  • If you have an Advantage plan, are they CURRENTLY participating in that plans network?
  • Do they accept Medicare assignment?
  • Does the doctor require up front payment for Medicare patients?

Again, most doctors DO participate in Medicare and most take assignment. A medical practice that accepts Medicare assignment means

  • you never have to pay up front for Medicare covered services
  • you never have to file claim forms with Medicare
  • Medicare and your supplement plan will pay your doctor direct, not you
  • your doctor can never bill you for excess charges

find medicare informationThe video report above missed the mark on a few things. Doctors that do not take assignment are not allowed to bill you up front. They are required to file your claims with Medicare and must wait until Medicare (and your supplement plan) pays you once the claim is adjudicated.

Finding doctors that take Medicare is not that difficult, but finding an affordable plan that meets your needs and budget can be difficult. In some parts of Georgia you may only have half a dozen Advantage plan choices and many of them may not include your doctor or hospital in their network.

However there are more than 170 Medicare supplement plans statewide. Finding a plan with our help is as simple as getting a personalized Medigap quote in the privacy of your home, picking up the phone or sending us an email.

Let us know how we can help.

 

#MedicareDoctors  #GeorgiaMedicareDoctors  #Turning65 #GAMedigapQuotes

How Obamacare Impacts Medicare Advantage Plans

Obamacare affected under age 65 health insurance but left Medicare alone. That popular belief is incorrect. Obamacare (ACA) which-medigap-is-best2reduces funding for Medicare plans and cut’s reimbursement to carriers. Taxpayer subsidies to “poor” people (those earning less than $95,400 for a family of 4) are funded in part by cut’s to the Medicare program. These funding cuts amount to $700 billion from 2013 through 2022.

Depending on which side of the aisle you are on determines whether you refer to these cuts as lower funding or savings.

No matter what you call it, the federal government will spend less on Medicare each year in order to fund Obamacare for the “working poor”.

 

Obamacare impacts how Medicare Advantage carriers are paid

According to Benefits Pro as of January 2015 20% of the Medicare cuts have been implemented and retirees are paying more for their Medicare Advantage plans. These higher costs come as

  • higher premiums
  • higher copay’s
  • higher deductibles
  • higher out of pocket
  • smaller networks
  • more HMO’s
  • fewer plan choices

senior-scratching-headMost Medicare plans began receiving less pay in 2012 but the cuts are to be phased in from 2012–2017, so we have a ways to go yet.

Under PPACA, plans also can qualify for a bonus payment for providing better care. Plans have to report data detailing how many of their members are routinely getting preventive care under the plan, as well as how many get additional support in managing chronic conditions such as diabetes. Plans receiving higher star ratings get higher bonuses, with the desired result being that the bonus program will encourage plans to focus on delivering a higher quality of care, thus increasing the value of the health care dollars spent by consumers.

There is only one 5 star plan in Georgia. Most are 3 to 3.5 stars and several do not qualify for a star rating.

 

Benefit changes because of Obamacare

Original Medicare as well as Medicare Advantage plan have certain benefits that must be included in all plans. “No charge” annual preventive exams are now the norm as are “lifestyle” counseling and information pamphlets. medicare-age-65-enrollment2

But Medicare Advantage plans have had a more drastic makeover than original Medicare and Medigap plans.

PPACA also introduced a new mandatory cap for all Medicare Advantage plans designed to cut member costs. The cap limits the total out-of-pocket costs a member can incur for Medicare covered services each year. The limit is set to $6,700 in-network right now, which is substantially lower than limits many plans had before the law and thus results in higher spending by the plan.

Most plans now have out of pocket maximums of $6700 for charges by par providers. These charges can run significantly higher when you use non-par providers. This is considerably higher than the average max OOP of less than $4,000 from just a few years ago.

Compare that with less than $150 OOP for our most popular Medicare supplement plan AND no networks. Our second most popular plan has less than $500 OOP (and often less than $300) and features premiums that are about 20% lower.

 

Georgia retirees in rural counties hit the hardest

The number of Medicare Advantage plans available to those living  in outlying counties shrinks every year. In the last few years at least 7 rural hospitals have closed, at least in part because of Obamacare.

  • Folkston – Charlton Memorial Hospital
  • Richland – Stewart-Webster Hospital
  • Hartwell – Hart County Hospital
  • Glenwood – Lower Oconee Community Hospital
  • McRae – Telfair Regional Hospital
  • Arlington – Calhoun Memorial Hospital
  • Eastman – Dodge County Hospital

stewart webster hospital smallOther hospitals like Ty Cobb in Lavonia may be shuttered before too long. CMS rules for Medicare Advantage plans require them to have a specific number of doctors and hospitals under contract in a given area before they are allowed to offer a plan. As regional hospitals close your choice of Advantage plans also dwindles.

Retirees in rural areas face higher premiums and PPO plans are being replaced with more restrictive HMO offerings. In some areas Advantage premiums of $50 – $70 per month (or more) are becoming quite common.

For a few dollars more you can have a Medigap plan, not have to worry about networks and have considerably less out of pocket.

Georgia Medicare Plans specializes in low cost Medicare supplement plans and tailoring a drug plan to fit your needs. Our average client saves over $1,000 per year in out of pocket drug costs. We showed one client how to save over $6,500 per year in premiums and OOP costs.

Don’t get tripped up by Obamacare changes to Medicare Advantage plans. Let us help.

Georgia Medicare supplement rates

 

#Obamacare  #MedicareAdvantage  #Medigap

 

Lagrange Medigap Rates

Lagrange Medigap rates vary considerably for the exact same plan. How do you find the plan that is right for you? Medicare supplement plan F is the most popular plan in Georgia and we have the best rates in your area. Medigap rates you won’t see anywhere else.

Lagrange is the county seat for Troup county with a population of 30,000 people lagrange medigap rates

Lagrange College is the oldest private college in the state.

Major employers in the area include Troup county schools, Milliken and Kia.

Prominent people from Lagrange include Fuller Calloway (textiles), Tom Jariel (news reporter) and Louis Tompkins Wright (physician)

 

Lagrange Medigap Rates

Did you know there are 37 carriers that offer Medigap plan F in Gainesville?

Medicare supplement rates for a female, age 65, non-tobacco range from $129 to $250 per month. Male rates and tobacco rates are slightly higher.

Click here to review Lagrange GA Medigap rates.

 

One carrier will bill you for the non-tobacco rate if you sign up for their plan when you initially start Medicare Part B.

There are currently 185 different Medigap plans available to Gainesville, Georgia retirees but only 6 Medicare Advantage plans. If you have a Medicare supplement plan you have 30 different Part D drug plans available to you.

Original Medicare and a supplement do not have any networks. You are free to use any doctor, lab or hospital anywhere in the U.S. without suffering a penalty because you used the “wrong” provider.

 

Medigap plans for people with medical conditions

If you sign up for a Medigap plan when you first go under Medicare Part B there are no health questions. Anyone can purchase any plan from any carrier, regardless of their health. After that you can change plans at any time but you must go through medical underwriting.

If you have any of the following conditions but have been symptom and treatment free for the past 2 years you may qualify for a standard rate with one of our preferred Medicare supplement carriers.

  • Alcohol or drug abuse
  • Anxiety, depression requiring hospitalization
  • Bypass surgery, carotid artery disease, heart attack, valve replacement
  • Cancer
  • Diabetes (without complications)
  • Leukemia
  • Stroke, CVA, TIA

Apply by phone. Get a decision within 20 minutes. If approved you will be given your policy number.

No other carrier does this!

 

Lagrange Medicare Advantage

Of the 6 Advantage plans in Troup county, on has a $0 premiums, the others range from $23 to $74.

All Advantage plans are PPO plans and only 4 include drug coverage.

HMO Advantage plans generally have very small networks with only a few doctors and hospitals that participate in the plan. If you go out of network for a non-emergency situation you may have no coverage under your HMO plan.

PPO plans have slightly larger networks and the non-par penalties are not as harsh as with HMO plans.

 

Lagrange providers

There are 320 doctors in Troup county that will accept ANY Medicare supplement plan. On average, about half that number will take patients with a Medicare Advantage plan. Of the doctors that do take Advantage plan patients you will find that most accept only a few plans and almost no one participates in all Advantage plan networks.

Troup county has 20 hospitals and every one of them will take Medicare and your Medigap plan. If you pick an Advantage plan, check to see which hospitals are in network.

Shop Lagrange Medigap rates now.

georgia-medigap-button

 

Do I Need a Medicare Supplement Plan and Medicare Advantage?

Medicare supplement and Medicare Advantage. What’s the difference? Do I need both? What is the difference in Medigap and Medicare supplement? Do AP20C7Advantage plans have more advantages? Can I change plans every year during open enrollment?

Which plan is better? Should I have an Advantage plan or Medigap?

That is a question only YOU can answer.  Consider the differences and then decide which plan fits your needs and budget.

Are you turning 65? Do you need help navigating the Medicare maze?

Call us. We can help.

 

Medicare supplement and Medicare Advantage

What is the difference?

A lot.

Do I need both a Medicare supplement plan and an Advantage plan?

Nope. Even if you wanted both, Medicare says you can’t have both.

So pick one or the other.

 

Medicare supplement plan F rates

What is the difference in Medicare supplement and Medicare Advantage?

Medicare supplement plans work with original Medicare.

  • No networks
  • Use any doctor, lab or hospital anywhere in the U.S.
  • Referrals not necessary to see a specialist
  • Keep your current doctor(s)
  • Your doctor cannot be dropped from the plan mid year
  • You can keep your plan every year.
  • Annual review not needed (for your supplement plan)
  • Out of pocket is clearly outlined and can be budgeted
  • Pick a drug plan that covers the drugs you need

 

Is Medicare Advantage Better?

The advantages of a Medicare Advantage plan are, the monthly premium is lower.
The disadvantages are:
  • you are limited in most cases to docs and hospitals in the network
  • the Rx is often paired with the plan and may not include the meds you need
  • your doctor can be drop out of the plan at any time
  • you may have to change your plan every year
  • you have to review the plan every year (participating network providers, meds, cost of health care, etc)
  • your out of pocket for in network only claims is almost always higher than Medigap
  • your out of pocket cap averages $6,700 (most 2018 plans) + out of network claims + Rx copay’s
  • you can find yourself out of network and incur penalties any time, anywhere
But other than that, the Advantage plans are great until you use them.

Can I change plans every year during open enrollment?

Medicare supplement plans do not have annual enrollment periods. When you first turn 65 you can purchase any Medigap plan with any carrier, no questions asked.
Medicare Advantage plan and Part D drug plans can be changed every year, but only during open enrollment. Most retirees will change their Advantage and Medigap changedrug plan every year or so, whether they want to or not. Each year the plans change and you MUST review to make sure you are not going to pay more for your health care than you expected.
Never ever take the “automatic” renewal option. Always ask your agent to shop and compare plans for you every year.
One of my Part D clients was prepared to take the automatic renewal from Cigna. Their new rate was dropping a few dollars and other than the addition of a deductible, the plan seemed like a good buy.
What they did not know (until I reviewed it for them) was this.
The renewal plan did not include all of her medications.
The renewal offer was $7 less than the Cigna plan I suggested but the difference in her out of pocket costs was significant.
Her expected annual prescription drug cost for the renewal offer was $2880.
The projected drug premium for the plan that was $7 higher but her annual prescription cost was only $1530. That additional $7 monthly premium saved her more than $1300 in out of pocket drug costs.
Had she accepted the automatic renewal she would have saved $84 in premiums but would have paid out more than $1300 for her medications.

Comparing Medigap plans is easy

Kind of.
Benefits are standardized and assigned a letter of the alphabet from A through N.
But Medicare only uses 9 of the letters
Medicare supplement plan F is the most popular. Also the most expensive and most oversold.
Plans G and N offer exceptional value.
Some carriers don’t offer all the plans.
AARP/United Healthcare does not off plan G. Neither does Blue Cross of Georgia (BCBSGA). Nor does Humana.
Mutual of Omaha (Omaha Insurance Company in Georgia) does not offer plan N. They did at one time, but not any more. Makes you wonder why, doesn’t it?
We never recommend a plan that does not have at least a 5 year renewal rate history.  That is to protect you.
Manhattan Life and Omaha Insurance Company have only been offering Medigap for a little over a year. Same for Companion Life.
There are over 250 different Medigap plans in Georgia. We have Medigap rates you won’t see anywhere else, but you can start your online shopping experience by clicking this button.
Georgia Medigap plans & Prices

Georgia Medigap plans & Prices