Medicare Things You Don’t Know

Medicare things you don’t know (but wish you did). Questions you never asked because no one told you. And you will pay dearly if you are not prepared.

There are things about Medicare that will trip you up when you least expect it. Not so much with Original Medicare, but there are things about Advantage plans no one mentioned. Medicare things you don’t know. Stuff like access to care and prior authorization.

Medicare Stuff About Advantage Plans

You may think you understand Advantage plans but my guess is there are things in this video that will shock you.

Almost everyone LOVES their Advantage plan until they have to use it. I get calls all year long from folks who say they can’t afford their Medicare plan and want a supplement.

Most GA Medicare Advantage premiums are $0. If they can’t afford their plan there’s a good chance they are incurring hundreds or even thousands of dollars out of pocket for claims.

I have a friend that has been bragging about his plan ever since he went on Medicare. He thought I was foolish for paying “all that money” every month for a Medigap plan.

A few years ago a cancer diagnosis was a shock. His provider had grant money to pay for his treatment so his out of pocket was minimal.

Now the Cancer is Back

Gary is learning things about Medicare he did not know. Such as prior authorization.

Before he can have a test ordered by his doctor, the carrier must APPROVE the test. It’s all about the money.

His oncologist wants him to have proton therapy but his plan will only pay for a less expensive protocol. Dollars drive many medical decisions when an insurance carrier controls your benefits.

Proton Therapy – It Helps Only a Few at a Wildly Extravagant Cost MedPage Today

All he wants to do is get well but his Advantage plan is running interference. His carrier is interested in saving money. THEIR money. Not his.

It’s all about the dollars. Just another Medicare thing he did not know.

What is Prior Authorization?

According to the Kaiser Foundation “80 percent of Medicare Advantage enrollees are in plans that require prior authorization for at least one Medicare-covered service“.https://www.kff.org/medicare/issue-brief/prior-authorization-in-medicare-advantage-plans-how-often-is-it-used/

Prior authorization is more frequently imposed for HIGHER COST services.

Reading further . . .

A potentially overlooked consideration is access to covered services; specifically, how prior authorization may affect beneficiaries’ access to covered services.

Medicare Advantage plans can require enrollees to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service.

On the other hand, Original Medicare does not require prior authorization for most services.

There are probably many things about Medicare Advantage plans you did not know. Limited access to care because of prior authorization requirements is probably just one of them.

#MedicarePriorAuthorization #MedicareAdvantage #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.

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.

Why Are Georgia Medigap Rates So High?

Why are Georgia Medigap rates so high? Which Medicare supplement carrier raises rates the most? Why are (this carriers) Medigap rates going up so much? Which carrier raises rates more? UPDATE 2017 – Wild times ahead! Many carrier rates are increasing by 10% to 15% and some even higher.

georgia medigap ratesThe most popular search term at Georgia Medicare Plans is for Georgia Medigap rates. One large well known carrier in particular dominates the searches more than any other Medicare supplement carrier.

That same carrier has handed out more rate increases since 2012 than any other Medicare supplement carrier. They increased rates ELEVEN TIMES since 2012!

Why is this? What is the answer?

The simple answer is, do your homework before buying.

  • Never buy on carrier name recognition alone
  • Don’t buy a plan based on rate UNLESS you also know the rate history for that carrier
  • Listen to your friends, but don’t buy a plan based solely on their recommendation
  • Never buy under sales pressure

When you make the right choice you can keep that plan for years and never have any regrets. When you turn 65 and enroll in Medicare, that may be your only opportunity to purchase a Medigap plan. There is only ONE open enrollment for Medicare supplement plans.

Why look at only a handful of Medicare supplement plans when you have the opportunity to compare over 170 different plans? Check out GA Medigap Quotes for instant, side by side comparisons of the most popular plans.

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If you don’t know where you are going you will never get there.

 

What’s up with Georgia Medigap rates?

Good question. The answer is not simple but I will do my best to explain. But first, here is a sample of queries that drove searchers to my site over the last few weeks.ga medigap rate increase

How often does Mutual of Omaha raise their Medicare supplement rates? What are Mutual of Omaha Medigap rates? Why are Mutual of Omaha Medicare supplement rates going up so much? Rate increases for United of Omaha? Which carrier has raised rates most often, Mutual of Omaha or Aetna?

Everyone our age remembers Mutual of Omaha’s Wild Kingdom. Tune in Sunday evening to watch Marlon Perkins track a mother lion and then close the show by saying “Just like the mother lion protects her cubs, Mutual of Omaha will protect you”.

Corny, but effective.

When asking about Medigap rate increases you need to understand there are 4 different carriers that trade on the Omaha name, not just Mutual of Omaha. Tracking rate history can be challenging at best and impossible for most consumers.

 

Georgia Medigap rate changes

Since 2012 Omaha carriers have increased rates no less than 11 times. Some rate increases applied only to legacy (in force) policyholders, some for new applicants, and some increase applied to both. Below is a summary of  changes in Georgia Medigap rates.

  • September 2012 – increase for United of Omaha modernized plans, new and in force
  • December 2012 – increase for United of Omaha standardized plans issued prior to June, 2010
  • July 2013 – increase for Mutual of Omaha standardized plans
  • August 2013 – increase for United World standardized plans issued prior to June, 2010
  • September 2013 – increase for new United of Omaha applications
  • October 2013 – increase for legacy (in force) United of Omaha modernized plan policyholders
  • October 2013 – increase for United of Omaha legacy plan N policy holders
  • December 2013 – increase for United of Omaha standardized plan policyholders
  • October 2014 – increase for United of Omaha plan N policyholders
  • August 2015 – increase for new and legacy Omaha Insurance Company modernized plan policyholders
  • October 2015 – increase for United of Omaha legacy modernized plan policyholders

That’s a lot of rate increases spread over 4 issuing carriers in less than 4 years.

And consider this. New applicants will eventually fall into the legacy class within a short while.

The carriers I recommend have had only 4 rate increases  (each) since 2012. Legacy policyholders receive the same rate adjustment as new policyholders. In other words, legacy policyholders are not burdened with frequent or higher rate increases so new applicants can enjoy lower rates for a while.

Legacy policyholders with carriers I suggest do not pay higher rates than those applying for new coverage.

 

 

Buying a Medigap plan when turning 65

When you first turn 65 you can purchase any Medigap plan you want, no questions asked. During your initial open enrollment it doesn’t matter if you medigap rate peacecan run marathons or if you have one foot in the grave.

In the future you can change plans any time you want, but only if you are healthy. There are no annual enrollment periods for Medicare supplement plans. The plan you buy when you turn 65 may be a plan you have to keep for the rest of your life.

If the premium is no longer affordable you option is to switch to a Medicare Advantage plan (lower premiums, higher out of pocket, no choice of doctors) or have original Medicare as your only coverage.

We help you find the right plan that meets your needs and budget so you can have peace of mind now and in the future.

 

Why limit yourself to one Medigap carrier?

Georgia Medicare Plans is appointed to represent over a dozen Medicare supplement carriers. In almost every situation we can offer you the absolute lowest rate for the plan you want.

But sometimes you might want to pay a few dollars more for long term rate stability.

Or you can just buy based on brand name and hope for the best.

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#GeorgiaMedigapRates  #MedicareSupplementRateIncreases  #GAMedigapRates #2017MedicareSupplementRates

13 Silent Signs of a Thyroid Problem

Symptoms of a thyroid problem are often vague, but if you notice any of the following thyroid symptoms persisting, or have more than one, see a doctor.

Source: 13 Silent Signs of a Thyroid Problem

Does Medicare cover thyroid testing?

As a general rule, Medicare Part B covers most preventive screening including most tests for thyroid issues. Do you have hypothyroidism (under-active thyroid) or hyperthyroidism (over-active thyroid)? How do you know? What kind of tests are involved in checking my thyroid? Will Medicare pay for those tests?

 

What happens when your doctor checks your thyroid?

Your thyroid rests just below your Adams apple. During a routine exam, such as your Welcome to Medicare exam, your doctor thyroidmay ask you to hold your head back and swallow. While you are swallowing your doctor is feeling for bumps or nodules on your thyroid.

If your doctor detects an abnormality in your thyroid they may recommend additional testing such as a thyroid scan and uptake, imaging testing or perhaps a needle biopsy.

Most diagnostic testing is covered by Medicare Part B. If you have Medicare supplement plan F your out of pocket for approved claims would be $0.

Several Georgia Medicare supplement plans have competitive rates. Often we can save our clients $450 per year or more with no loss of coverage.

Shop and compare now. Your information is NEVER sold. Instant GA Medigap quotes.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

What is hypothyroidism? Hyperthyroidism?

Hypothyroidism is a medical condition where your gland does not produce enough hormone. If your thyroid is under-performing you may feel sluggish.

Other symptoms may include an irregular menstrual cycle, constipation, loss of hair, unexplained weight gain or difficulty losing weight.

Hyperthyroidism is the opposite of hypothryroidism. In this situation your gland produces too much hormone.

Symptoms include quick weight loss, rapid heart rate, you sweat a lot, are moody or anxious.

If you have any of these symptoms you should see a doctor.

Both hypothyroidism and hyperthyroidism are easily treated with prescription medication.

Other common thyroid issues include:

  • goiter
  • thyroid nodules
  • thyroiditis
  • thyroid cancer

Ask your doctor if you have any concerns, and relax. The exam and testing is usually covered by Medicare and your Medigap policy.

 

If you found this article to be of help, share this link with your friends.

 

 

#MedicarePartB  #13SignsOfThyroidProblems #Hypothyroid  #Hyperthyroid #MedicareSupplementPlanF #GAMedigapQuotes