Who Can Help With Medicare Questions?

Medicare information. Where can you find answers to ALL your questions about Medicare?

Medicare Information GA Medicare Expert
Medicare Questions – Ask a Medicare Expert

Medicare.gov is a great resource. As someone who has used that site for many years I can tell you this.

The information is mostly accurate and unbiased. Medicare.gov has answers to things you have not even considered.

Only one problem.

Unless you know EXACTLY how to ask your question you may never find the answer.

Who CAN Answer Your Medicare Questions?

Shameless plug here.

Try asking the GA Medicare Expert, Bob Vineyard.

I didn’t pick that title. That was given to me by my clients. Over 500 of them all over the state of Georgia.

All have original Medicare.

All have a Medicare supplement plan.

Tap into my 40+ years of health insurance experience at no charge. And just like all my clients, I am enrolled in Medicare and have a Medigap plan.

You Have Medicare Questions? We Have Answers

Common Questions

When can I sign up for Medicare? How much does Medicare cost? What is Medicare Part C? I hear some plans are free. How can that be?

Can I save money by going direct to the carrier? Who will give me unbiased information?

Can I keep my doctor?

Many of your questions are available on my YouTube Channel.

You can also call or email me. If you get voice mail, leave a message. And you will NEVER hear “Press 1 for English“. I will call you back.

An Offer You Can’t Refuse

Here is my offer. You have questions about Medicare? Give me a call. Initial calls usually last 10 – 15 minutes. The length of time is up to you.

Put me through the drill. Ask any Medicare question.

If you don’t like what you hear, or don’t feel you are getting valuable information, say goodbye and we part as friends.

Nothing personal. It’s just business.

But if you feel I can help, consider letting me EARN your business.

We move along at YOUR pace. Never any sales pressure.

People love to buy but they hate to be sold.

That is my offer you can’t refuse.

Never any risk and you just might learn something.

#GAMedicareExpert #MedicareInformation #MedicareQuestions.

Why Are Medicare Advantage Plans Popular?

Medicare Advantage plans seem to be popular. But why? What is the appeal? What is so attractive about these managed care plans? Are they really free? GA Medicare expert Bob Vineyard explains.

medicare advantage popular
Why are Medicare Advantage plans popular?

Why are GA Medicare Advantage Plans Popular

Are you turning 65 and confused about the Medicare process? Why is it so difficult? Why do my friends, and many agents as well, want to push me in the direction of an Advantage plan? Low premiums are attractive. So is “free”. Is there really such a thing as a free lunch?

Medicare Advantage plans are like the Hotel California. You can check in but you may never leave.

Some people turn to Advantage plans when they first go on Medicare at age 65. Low premiums, many are $0. Extra benefits like dental, vision and some have gym memberships. Drug plans are often included in the plan. “One stop shopping”.

What’s not to love?

Why do sick people leave Medicare Advantage plans?

Georgia Advantage Plan Traps

Have you ever bought something and later realized you had no idea how it works? Maybe the sales person forgot to mention key details that might have changed your decision.

If something is too good to be true it probably is.

There is nothing inherently wrong with GA Medicare Advantage plans. You just need to understand what you have signed on for. Here are a few questions you need to ask.

Preferably BEFORE you enroll.

  • Is the plan a PPO or HMO?
  • Do I need a referral to see a specialist?
  • Will my doctor take my Medicare Advantage plan?
  • Are there any out of network penalties?
  • Can I change plans at any time?
  • Can I return to original Medicare and a supplement plan if I want?
  • Does the out of pocket limit include prescription medication?
  • What will my health care really cost if I use an out-of-network doctor?
  • Will my claims be paid if I use a non-par provider?

If you ask the right questions and are satisfied with the responses, the Medicare Advantage plan could be just what you need.

When you enroll in a managed care Advantage plan, the insurance carrier, not Medicare, provides your benefits then reviews, adjudicates and pays your claims.

“No premium” plans are not free. You still have to pay for health care and prescription drugs.

There is no free lunch.

Health care is not free. SOMEBODY pays the bill. Either you or the insurance carrier.

But you knew that all along, didn’t you?

This Doesn’t Look Like Kansas Anymore

Managed care plans often have small provider networks. Fewer doctors. Fewer hospitals. The question is, how much smaller?

A Kaiser Foundation survey found that on average “Medicare Advantage plan networks included 46% of all physicians in a county.” Some plans had fewer than 5 thoracic surgeons, fewer than 5 neurosurgeons and fewer than 5 radiation oncologists.

This isn’t JUST about dollars. It is also about access to health CARE.

Each calendar year brings a new list of approved providers. Will your doctors be included or will they disappear into a dark hole?

Are you willing to change doctors to save money or pay more to keep your doctor?

Are claims submitted by non-par providers covered by your plan?

A recent government report says seniors are more likely to LEAVE managed care plans when they get sicker.

Managed care is great when you enjoy good health. But how much will your plan cost when your health changes dramatically? Can you really afford to be sick?

Medicare Advantage Final Exam

Many who enroll in a managed care plan never really understood how the plans work . . . until they had large claims. Don’t be one of them!

Do you like your current doctor(s)? Would you like to keep him or her?

Can my doctor refuse to treat me if I have a Medicare Advantage plan?

Do you want to direct your own health care, pick your own doctors and hospitals, or would you rather let an insurance carrier do that for you?

Is it easier for you to budget $120 per month to cover almost all of your health care costs or are you OK paying for your health care only as needed?

Could you budget $6,000 per year or more for your health care (not including drugs) if you had to?

How long could you afford to pay that much? One year? Two years? Longer?

Would you trade places with Marsha’s husband?

You can change your Advantage plan every year. Same is true for your drug plan. You can also enroll in original Medicare any time you want without answering health questions.

But if you want to change to a Medicare supplement plan you may need to prove you are healthy. Your best shot at getting a Medicare supplement plan is when you first enroll in Medicare Part B. If you wait until you NEED a Medigap plan you may not be able to get one. That is Catch-22.

Many will only have one chance to enroll in a Medigap plan. Will you be one of them?

Shop GA Medicare rates.

Medicare.

You have questions.

We have answers.

$GAMedicareExpert #MedicareAdvantagePlans #FreeMedicarePlans  #MedicareHMO  #MedicarePPO

How Much Does Medicare Cost?

Medicare, how much does it cost in 2019? Premium costs for original Medicare Part A are “prepaid” for most people. You or your spouse may have qualified based on past Social Security earnings. Medicare Part B standard premiums in 2019 are $135. If your MAGI is above the threshold you may owe a tax in addition to your Part B Medicare premiums. Are Medicare premiums tax deductible?

How much does Medicare cost?

How to Enroll in Medicare

When do I enroll in Medicare? How do I sign up for Medicare? At what age can I begin Medicare benefits?

GA Medicare expert Bob Vineyard explains.

These are all things Georgia citizens that will turn age 65 need to know.

Medicare Premium Costs

In addition to your Medicare premiums, you may incur additional costs for supplemental coverage, prescription drug plan or a Medicare Advantage plan.

Most people pay nothing for Medicare Part A if they have at least 30 quarters of earned income and paid Medicare taxes on those earnings.

Popular Georgia Medicare supplement plan premiums start around $100 per month in 2019. Popular GA Medigap plans limit your out of pocket expenses to the Medicare Part B deductible ($185 in 2019).

Medicare Part D monthly premiums are as low as $14 in 2019.

How Much Does Medicare Cost

Medicare Advantage Plans

Many people do not pay a monthly premium for Medicare Advantage plans but that does not mean they are “free”. If you select an Advantage plan you will need to budget for planned and unplanned out of pocket health care expenses. Outpatient care may incur copay’s starting at $10 while some procedures may run $100 or more. Hospital inpatient care imposes a daily copay of several hundred dollars for a specific number of days.

Most GA Advantage plans are HMO models (2019) with small networks. HMO plans reserve the right to deny payment for claims incurred outside of your network.

Currently, many Advantage plans limit your annual out of pocket expenses for health care to $6,700 per year. These amounts do not include prescription drugs. If you use non-par providers your out of pocket expenses could be considerably higher.

When you have a Medicare Advantage plan you must play by their rules if you want your claim paid.

#GAMedigapRates #MedicarePartAPremium #MedicarePartBPremium #MedicarePartDPremium #MedicarePartCPremium #GAMedicareExpert

Medicare Supplement Rate Increase History

How often do Medicare supplement rates increase? What is average premium increase? Where can I find supplement plan rate histories? Do plan F Medigap rates increase more than other plans? Why are my rates so high?

All good questions but here is something you should know.

Tracking rate increase histories doesn’t matter. This video explains.

Medicare Supplement Rate Increase History

Why Medicare Supplement Rate Increase Histories Don’t Matter

Don’t worry about previous rates. The history of a particular plan or carrier does not allow you to predict future rate increases.

  • Renewal rates are market driven
  • Renewal rates also reflect loss ratios
  • Loss ratios impact renewal rates but are tempered by market share
  • Medigap carriers rarely stay in a particular market longer than 3 or 4 years
Medicare premium sticker shock
Medigap Rate Sticker Shock

Medicare supplement rates are market driven

During the last few years most carriers did not care about offering competitive plan F rates. This is especially true for “household” name brands. Carriers that market direct to consumers know folks will buy their product without shopping rates. Popular brands include Anthem Blue Cross, Mutual of Omaha and AARP/United Healthcare.

Name recognition, size and financial strength may be a consideration for most products. But this criteria does not extend to Medigap plans.

All Medicare supplement carriers pay claims on a timely basis. Most are paid in 3 to 5 days once the claim is received from Medicare.

When you pay more for your Medigap plan you don’t get more, you simply paid too much.

Some carriers that are new to the market are aggressively pricing their G plan. Don’t get sucked into a low entry rate. Ask #GAMedicareExpert Bob Vineyard for advice. Never any charge.

Loss ratios drive renewal rates

Some carriers will intentionally underprice their plans to attract market share. These plans and rates may be very competitive for a year or two before the renewal increases are double digit.

Don’t get lured into a low price offered by a carrier that has only been in the Georgia Medicare market a few years.

Low rates and loose underwriting will generate high loss ratios. What follows are huge rate increases and the possibility the carrier will withdraw completely from the market.

Medigap carriers come and go

As of May 2019 there are almost 50 carriers writing Medicare supplement plans in Georgia. Over the last 4 years or so we have seen at least 20 carriers leave the market and be replaced with lower priced plans. Often the departing carrier is owned by a large, brand name carrier. The parent company introduces another subsidiary with lower rates than the retired carrier.

Don’t get sucked into buying a plan from a carrier that is owned by a household name. That subsidiary will probably leave Georgia within 3 to 4 years. Future rate increases are almost always significantly higher than companies that are still writing new business.

Ask a Medicare expert for advice

Bob Vineyard has over 40 years in the health insurance industry and is also on Medicare. You have questions? We have answers.

Here is my offer.

Give me 10 to 15 minutes by phone to answer your questions. If you don’t feel comfortable with my approach or believe you can get better help and advice elsewhere, move on. We part as friends.

This isn’t personal, it’s just business.

But if you like what I have to offer and would like my help navigating the Medicare maze, let’s do business. Never any pressure. It is always at your pace.

This is what I call an offer you can’t refuse.

Why Do I Need a Medicare Insurance Agent?

Medicare insurance agent. Who needs them? Medicare is simple. Pick the lowest rate. Why use and insurance agent? Cut out the broker. Go direct to the carrier. Save the commission.

You Don’t Need an Agent

Medicare expert? Truth is, you don’t need an agent to SELL you a Medicare plan. You can use Medicare.gov, go direct to a carrier or even use one of those online “FREE” quote services. But how will you know if you picked the right plan or paid too much?

Ask a Medicare expert.

Will you save money by eliminating the middleman?

No. This video explains.

Does an Insurance Agent Offer Real Value?

Experience.

About 70% of those who turn 65 and are enrolling in Medicare for the first time have never bought health insurance before. Most people will need to get it right the first time. For many there are no Mulligans. No do-overs. This may be your only chance to buy a Medicare supplement plan.

Medicare supplement rates change every year. Old carriers are retired. New carriers enter Georgia with low initial rates.

You can change Medigap plans anytime you want . . . as long as you are healthy. Medicare expert and insurance agent Bob Vineyard will help you find the right plan that fits your needs and budget.

Those Pesky Drug Plans

Medicare Part D drug plans are complicated. Deductibles, formularies, copay’s, preferred pharmacy’s change every year.

Too many people pay too much for their Medicare drug plan.

Could be they bought the same plan their friends have. Wrong.

Maybe they bought from the carrier that issued their Medigap plan. Wrong.

Sometimes seniors will shop on their own and pick the plan with the lowest premium. Not always correct. Not always wrong. But the criteria is definitely wrong.

Many times they buy a plan suggested by an insurance agent that really doesn’t understand Medicare Part D. This happens way too often.

Check out my YouTube Channel and review drug plan videos.

Learning the Language

Welcome to the world of Medicare where almost everything is a TLE and has an acronym. Here is a friendly introduction.

TLE = Three Letter Entity

CMS = Center for Medicare (and Medicaid) Services

MSN = Medicare Summary Notice

PDP = Prescription Drug Plan

ABN = Advance Beneficiary Notification

Having fun so far. You can’t tell the players without a scorecard.

Confused?

You have questions. We have answers. Call or email.

Do You Need a Medicare Expert?

Nope.

You can DIY. (Do It Yourself).

But if you mess up who can you blame?

You can spend hours online researching. Attend seminars. Invite strangers (insurance agents) into your home.

But they don’t leave until you buy something or call the cops.

You could also sort through the mountain of information that comes in the mail. Ask your hair stylist or members of your bridge club. Does anyone still have bridge clubs?

Buy direct from a name you trust. Here is a tip. Medicare carriers with familiar names often overcharge, sometimes by hundreds or thousands of dollars per year.

Why?

Because they can.

They know you are buying on name recognition and have not researched. You trust them to treat you right.

They will take advantage of that trust and profit from your lack of understanding.

Give Me 10 Minutes

That’s all I ask.

Look over my website. Watch my videos. Call or email.

Yes, I am an insurance agent. But also an expert with over 40 years experience.

And just like you, I am enrolled in Medicare.

If you don’t feel comfortable with my advice, move on. No hard feelings. I don’t chase. I don’t beg.

Either you want my help and advice or you don’t.

Not only will I save you a lot of time and keep you from chasing rabbits, but you will also learn how to maximize your Medicare dollars.

And isn’t that what this is all about? Finding real value in the advice offered by a Medicare insurance expert.

#GeorgiaMedicareExpert #GeorgiaMedicarePlans

International Travel Medical Insurance

Does Medicare Cover Travel Outside the U.S.?

Original Medicare has nominal coverage outside the United States. Medicare defines “outside the U.S. as anything OTHER THAN the 50 states, Districe of Columbia, Puerto Rico, U.S. VIrgin Islands, Guam, American Samoa and the Northern Mariana Islands.

For more details review Medicare Coverage Outside the United States.

international travel medical coverage


International Travel Health Insurance

For many years I have recommended the Atlas Travel Insurance plan from HCC.

Choose a deductible from $0 to $5,000. Most will pick $500 or $1,000.

Maximum amount of coverage limit of $50,000 to $2,000,000. For many, a limit of $100,000 or $250,000 should work.

Policies should start on the day of departure. You can let coverage end the day you are to leave and return home, but I suggest adding a few days on the back end.

Once your policy expires, there are no extensions of coverage.

International travel medical insurance plans include air ambulance, translation of medical records and repatriation of human remains.

More details on foreign travel health insurance and specimen policy here.

Click the link, enter your information, quote and apply.

It’s that simple.

Medicare Supplement and Travel Outside the U.S.

If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan:

  • Covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care.
  • Pays 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.

Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000.”

Atlas International Travel Health Insurance

The industry-leading Atlas Travel Series now includes many new benefits, services and features that make it a leading option for individuals and families who travel internationally.

The policy now includes a benefit to be used in case of Natural Disasters and expanded coverage for Incidental Trips Home. This innovative product also includes coverage for Acts of Terrorism, Political Evacuation, and Complications of Pregnancy. Non-US citizens traveling outside of the US will benefit from our updated rating structure. State of the art travel and emergency medical assistance services are part of every Atlas Travel Series plan.

In addition, the Atlas Travel Series allows you to extend and/or renew your coverage for up to 36 months. Click for details on the Atlas International Travel Medical plan.

Georgia Medicare Gives Thanks

Georgia Medicare Looks at 2018

As Dickens said, “This is the best of times and the worst of times.” Like all years, there are times when things are good and times when things are not so good. From a business perspective I would give this year a 9 on a scale of 10. Georgia Medicare expert reflects on 2018.

Georgia Medicare expert

The Good News

Georgia Medicare supplement clients continue to bless me with referrals. My business grows mostly by word of mouth. When my advice is useful clients remember and pass my name along to their friends.

Like that old shampoo commercial where Heather Locklear told two friends about Faberge, and they told two friends, and so on.

Good new spreads like wildfire, and it is appreciated. With more than 500 GA Medicare clients, new referrals come in almost every month.

Thank you for being generous and sharing my name with your friends.

Georgia Medicare YouTube Channel

After years of planning and hoping it would happen, I finally implemented my Georgia Medicare YouTube channel in early summer. With the help of Christy Sanchez this labor of love is now a reality.

The videos are not fancy or technically complicated. It’s just me talking to the camera the same way I speak to you on the phone. Feel free to like, share and comment on any of the videos.

Of course you can also ask questions.

Say Hello to New Medigap Carriers

I currently count almost 60 insurance carriers offering Medicare supplement plans in Georgia. Many are brand new to the Medigap business. Others are new to Georgia.

At least 6 carriers are new to the Georgia Medicare market. Each one has cut rates to the bone in an attempt to gain market share.

It’s a race to see who can offer the lowest Medigap rate.

For at least a year.

New carriers include Lumico, Western United (late 2017), Everest (late 2016), American Continental, Prosperity (gotta love that name), Mass Mutual, Unified and Pan American. I might have missed a few but that’s a mouthful.

I generally don’t recommend a carrier until they have been here at least 3 years. In the past carriers (like AFLAC) have either disappeared from the market or blew up their rates on renewal in the first 3 years.

I don’t need that kind of drama in my life and neither do you.

Say Hello to a New Name for an Old Friend

One shining star is Anthem Blue Cross. BCBSGA has been co-branded with parent Anthem for a few years now. As of July 2018 the Anthem name is on all new Medicare plans in Georgia.

Of course you can call them direct or use an agent like myself. When you go direct you are a “house account”. You will never know who will answer the phone or anything about them. 

Last week they could have been asking if you wanted fries with your meal.

When you call me you will never hear “Press 1 for English”. You get me or voice mail. Leave a message and I will call you back.

No extra charge for my 40+ years experience.

You can enroll in an Anthem Medigap plan using my link . . . if you have an hour or so to kill. 

https://brokerportal.anthem.com/ac/BobVineyardAnthemGA

Or call me direct. I can take your information in about 10 minutes.

You choose.

The Bad News

A few carriers like Equitable, Manhattan and Aetna Health and Life stopped writing new Medigap business in Georgia. If you have a plan with them you can keep it as long as you pay your premiums.

I hope to move as many as possible away from these carriers in hopes of seeing fewer and smaller rate increases at renewal.

Thank You!

Thank you for all your support, for passing my name along and especially the kind words for my Georgia Medicare YouTube Channel.

I look foward to helping as many people as possible to navigate the Georgia  Medicare maze.

Do You Want Fries With That?

Would you like fries with your Medicare plan? What do you know about those who offer advice about Medicare?

Picking a Medicare Plan is as Easy as Ordering Lunch

Picking a Medicare plan while blindfolded is what happens too often. Almost no one understands Advantage plans. Medicare drug plan deductibles? Who can explain that? Much easier to pick a plan without a deductible. You can’t go wrong there.

Medicare supplement plans are easy. All plans with the same letter are identical. Just go with the plan with the lowest premium. Right?

Maybe you will appreciate my Shop Like a Boss video, explaining how to search for Medicare information.

No need to ask an insurance agent. They cost too much.

Questions You Really Should Ask

How long has the agent or carrier rep worked the Medicare market? Maybe feel more comfortable talking with someone at Medicare.gov or a volunteer and a not-for-profit organization.

Surely they will be impartial?

Or will they?

Turning 65 Medicare Options

How does Medicare work?

Bob Vineyard explains in this Georgia Medicare Minute video

If you are turning 65 and enrolling in Medicare, this may be your only chance to purchase a Medigap plan. Here is your guide to understanding GA Medicare.

You don’t have to receive Social Security to enroll in Medicare insurance. CMS is the agency that oversees Medicare.

Senior healthcare insurance is commonly used to describe Medicare.

How to enroll in Medicare? You may sign up for Medicare 3 months before your 65th birthday, the month you turn 65, and 3 months following your 65th birthday. You may enroll online (highly recommended), by mail or by visiting a Social Security office.

Original Medicare has 4 parts.

Medicare Part A covers hospital inpatient charges and has a per admission deductible

Medicare Part B is for outpatient health care treatment. Doctor visits, labs, X-rays, MRI, CT scan (CAT scan), ambulance, ER, outpatient clinics, etc. Essentially any Medicare approved health care received outside the hospital setting. Treatment considered medically necessary under Medicare guidelines. Medicare Part B has a calendar year deductible. Once satisfied, Medicare pays 80% of the approved charge, you are responsible for the remaining 20%.

Most seniors worry about hospital stays, but your major expenses will more than likely fall under Medicare Part B outpatient expenses. Original Medicare stand alone has no cap on your out of pocket expenses.

You pay until you run out of money, get well or die.

Medicare Part C is now referred to as Medicare Advantage. More on that later.

Medicare Part D covers outpatient prescription drugs. Some Advantage plans have drug coverage built into the plan.

Medicare Supplement or Medicare Advantage?

Medigap and Advantage plans cover the same things, but what you pay out of pocket for your care, and where you receive your care, is very different.

Original Medicare does not have networks. You can use any doctor or hospital anywhere in the US. Another plus is the ABN form which is only used with Original Medicare.

Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO.

If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.

Non-emergency out of network care charges may be denied if you have an HMO.

Medicare Questions – FAQ

How Much Does Medicare Cost?

In 2018 most Advantage plans issued in Georgia limit your out of pocket for approved in network health care expenses to $6700.

The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.

Some cancer centers, such as Mayo Clinic, Sloan Kettering and MD Anderson may not participate in certain Medicare Advantage plans.

Medicare and Cancer

Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.

Chemotherapy drugs administered in a doctor’s office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.

This is why most of us chose a Medicare supplement plan in 2018. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.

We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.

According to the Mayo clinic, “new cancer treatments are routinely priced at over $100,000 per year of treatment.”

A study from the Medicare Rights discovered the number one reason for disenrolling from a Medicare Advantage plan was “provider access problems”. Number 4 on the list was “cost sharing too high”.

Who is giving you Medicare advice? An experienced agent who is enrolled in Medicare or someone that works in a fast food restaurant?

#GeorgiaMedicarePlans #GAMedigapQuotes #Turning65 https://youtu.be/uMROeyRxqEI

Medicare Open Enrollment 2019

Medicare Open Enrollment 2019. Shop Medicare supplement plans and Part D. New, lower Medigap premiums. Are higher drug costs coming in 2019?

Who is invited? Who should stay home?

Can anyone help navigate the Medicare maze?

 

Medicare Open Enrollment 2019

So much information. So much confusion. Medicare Open Enrollment is not for everyone, and certainly not for the faint of heat.

If you think you already have all the answers, don’t read this post. If you believe Medicare open enrollment is for everyone you will probably learn something.

Medicare AEP is not a casual stroll. For most people, this is the only time you can change your Part D drug plan or Medicare Advantage plan.

Make a mistake and you will have to live with that decision for a year.

 

Be Prepared

Before you enter the annual election period, do this.

  • Make a list of all doctors including name, address, phone.
  • List all area hospitals, especially the ones you have used.
  • Make a list of all medications including dosage, refills, prescribing doctor and pharmacy.

Be aware of the donut hole and look for ways to avoid that trap. Make use of generics and off plan purchases.

Look for FDA approved generics and ask your doctor before making a change.

 

Part D Jungle

If renewing, get your drug list ID and password date from your last drug plan finder.

If renewing, study your ANOC for changes.

Use Medicare.gov for reviewing Advantage and drug plan options.

Avoid using Medicare.gov for PDP comparisons prior to October 25.

 

Review Medicare Supplement Options

Medicare.gov and the GA DOI site is essentially useless when comparing Medicare supplement options.

Most Medigap quote engines only list a handful of options and rarely have plans with the best value

Many quoting sites will sell your information to numerous agents; some don’t provide instant quotes

Never put anything on auto-renew unless you like unpleasant surprises.

 

Understand the Differences

Both Medigap and Advantage plans cover the same types of medical treatment, but what you pay out of pocket for your care, and where you receive your care, is very different.

Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO.

If you receive non-emergency out of network care under a PPO you may have higher copay’s and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.

Non-emergency out of network care charges may be denied if you have an HMO.

 

Medicare Advantage Considerations and Cancer

In 2018 most Advantage plans issued in Georgia limit your out of pocket for approved in network health care expenses to $6700.

The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.

Some cancer centers, such as Mayo Clinic and MD Anderson do not participate in Medicare Advantage plans.

Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.

Chemotherapy drugs administered in a doctor’s office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.

This is why most of us chose a Medicare supplement plan in 2018. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.

We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.

According to the Mayo clinic, “new cancer treatments are routinely priced at over $100,000 per year of treatment.”

5 Medicare Open Enrollment Tips You Must Know

Understand how Medicare works. Open enrollment only comes around once a year. Take advantage of this time to review all your options.
#GeorgiaMedicarePlans #GAMedigapQuotes #Turning65
How does Medicare work? Open enrollment 2018

 

Medicare Insurance Complaints

Medicare insurance complaints. Should I be concerned? Complaints can fall into many areas, including:

  • Why is my renewal premium so high?
  • Will my doctor accept this insurance?
  • Why doesn’t Medicare.gov list this company on their website?
  • How do I know the Medicare supplement insurance will pay my claims?
  • Can I change Medigap plans during open enrollment?
  • Can I change Medicare insurance plans at any time?
  • Where can I find BBB ratings?
  • Where do I find the rate increase history for (AARP, Mutual of Omaha, Blue Cross . . .)

You have questions. We have answers.

Medicare insurance complaints

 

Medicare Insurance Complaints

We speak with over 1,000 people each year. We take the time to answer, and sometimes research, solutions for their problems. Every phone conversation is followed up with an email that summarizes our discussion and provides links to documentation.

All we ask in return is that they allow us to offer a Medicare supplement rate quote. Some buy a plan from us, some don’t. Never any pressure. People love to buy but hate to be sold.

Why is my Medicare insurance renewal premium so high? In most cases you bought the wrong plan from the wrong carrier. Medigap plan F is overpriced and oversold. Also, many insurance carriers think they are a cable company. Give you a low first year rate then raise them considerably the next year. While you are paying a high rate they offer the same plan to new applicants at rates that may be 25% lower.

Will my doctor accept this insurance? Any doctor, lab or hospital that accepts Medicare assignment will also take your Medigap plan. When you have original Medicare and a supplement plan there are no networks and no penalties.

Why doesn’t Medicare.gov list this company on their website? Medicare does not approve or directly regulate Medicare insurance supplement plans. Medigap plans are approved at the state level. Any Medicare plan offered by an agent licensed in the state of Georgia is also approved by the state.

How do I know the Medicare supplement insurance will pay my claims? Claims submitted by your doctor or other medical provider go direct to Medicare for review and approval. Once adjudicated and approved by Medicare, the claim goes directly to your Medigap carrier. Medicare supplement claims are normally paid in 3 – 5 business days from receipt. Medigap carriers are not allowed to deny claims approved by Medicare.

Can I change Medigap plans during open enrollment? Medigap plans only have ONE open enrollment. When your initial Medicare Part B coverage begins you may apply for or change Medicare supplement plans at any time during the first 6 months. Drug plans (Part D) and Advantage plans can be changed during the annual enrollment period.

Can I change Medicare insurance plans at any time? You can change your Medicare supplement insurance plan at any time. However, if you have been enrolled in Medicare Part B longer than 6 months you will need to prove you are insurable.

Where can I find BBB ratings? The Better Business Bureau does not evaluate and rate Medicare insurance carriers.

Where do I find the rate increase history for (AARP, Mutual of Omaha, Blue Cross . . .). The easiest way is to call and ask. We have new business and renewal rate histories for many of the Georgia Medigap carriers. We will also quote current Medicare supplement rates by phone and tell you which plan and carrier I used when I went on Medicare in 2015.

georgia medicare supplement rates

Questions About Medicare Supplement Rates?

Why make your decision after seeing rates from only a few carriers. Most of the people we talk to bought the wrong plan and are paying too much. They allowed a salesman to talk them into buying something they don’t need and can no longer afford.

We do things differently.

We prepare a customized Medigap rate quote for those who are interested. The report shows rates and plans for not just a few, but ALL carriers based on your age, gender and zip code. These are rates you will not see anywhere else. Other brokers are not willing to be transparent but would rather show you one or two plans and say pick one.

We show you 30 or more and answer your questions. How simple is that?

 

Related Questions about Medicare Insurance Complaints

Consumer sights are often notoriously unreliable as a resource. There is little or no fact checking. Carriers are rarely (if ever) offered a chance for rebuttal. And there is this.

When did you ever find a consumer site where anyone had something GOOD to say about an insurance carrier?

Most of the complaints about insurance in general revolve around insurance claim denials. But those complaints do not address Medigap insurance.

Just an FYI, Medicare supplement insurance carriers cannot deny ANY claim approved by Medicare. There is one exception. If your coverage lapsed due to non-payment of your premium they are allowed to deny claims incurred while your policy was in a lapsed state.

So what about these consumer complaint sites?

Consumers sometimes will read comments about one line of coverage offered by a carrier and assume that applies to all lines. I ran into this recently when a carrier I had suggested “got bad reviews” according to my prospective client. I was trying to save him money over a plan suggested by another agent. That agent showed this gentleman these reviews.

I had told the salesman up front that I could not purchase the insurance until after the first of the year. He pursued until we agreed to get the minimum of the policies he offered and told us about the free look guarantee. 

The problem here is the pushy agent and has nothing to do with the carrier. I never “force” a sale. In fact, I don’t “sell” anything but I do inform and let the consumer decide if they want to buy, what they want and when they are ready to proceed.

Also, it is unclear what type of insurance is involved. It could be Medigap or something else. Regardless, this is an AGENT complaint and that person should be reported to the carrier.

I recently submitted a claim including death certificate on a policy that has been in effect since 2008. I am the policy owner and all my documents were intact. Because this death was police involved (meaning the decedent was shot by the police), they sent my claim to outside investigator to be certain that I was not involved.

This complaint was probably about a life insurance policy or accident policy. It is not a Medigap policy. The only time a Medigap carrier will ask for a death certificate is when the policy is being cancelled by someone other than the insured and the reason given is the death of the insured.

The carrier was right to have an investigation. If a beneficiary of a death benefit was involved in or contributed to the death the carrier has a legal right to pay someone other than the named beneficiary.

Other complaints about this carrier on this same site have nothing to do with Medicare supplement insurance.

 

What if You Still Have Questions?

Ask the agent.

If the agent appears evasive, or does not understand your concern, you might need a new agent.

Georgia Medicare Plans has no problem addressing your questions or concerns. If we don’t know the answer we know where to find it. And we always confirm your question and our answer by email. That way neither one of us has to rely on memory.

 

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