Turning 65 and Medicare Advantage Plus

Are you turning 65 in Georgia? Do you need Medicare Advantage Plus? What exactly is the “plus” to a Medicare Advantage plan? Why is the agent pushing Medicare Advantage over original Medicare and a Medicare supplement (Medigap) plan? If you buy a Medicare Advantage plan for the low premium, do you need to spend extra dollars on a plus plan? (Updated 5/4/2018)

 

Turning 65 and Medicare

Most people deal with aging in good fashion, but there is something about turning 65 that turns your world upside down. It doesn’t matter if you have retired early, are going to retire at 65 or keep on working.

At 65 you have some decisions to make. turning 65 Medicare

Some involved Social Security. Should you start early at age 62? Am I better off taking Social Security at age 65 or waiting until NRA (“Normal” Retirement Age as defined by Social Security) at age 66? What about delaying my Social Security until age 70?

And then there is that Medicare thing.

Is a Medicare Advantage plan right for me? Do I need a plus plan as well?

 

Sharon is turning 65 and signed up for Medicare Advantage Plus

Sharon turns 65 in a few months but, like all other Georgia seniors, is bombarded with mail and phone calls about Medicare options. She responded to a solicitation and allowed this “nice man” to come to her home explain her options.

For some reason the only plan he explained initially was a new Medicare Advantage HMO from Piedmont Wellstar. Her doctor participated in the plan, and the $0 premium was certainly attractive, so she agreed to sign up …………. 4 months early.

 

Will your Medicare Advantage Plan be Available Next Year?

(Updated 5/4/2018 – Piedmont Wellstar Medicare Advantage stopped offering coverage in 2016)

The $10 PCP copay’s were lower than other plans, as were the $30 copay’s for specialists. The Medicare Advantage plan included several Atlanta hospitals affiliated with Piedmont or Wellstar including one hospital less than 5 miles from her home.

Sharon is mostly healthy but she did have an emergency situation last year and had to spend a few days in the hospital then follow up doctor visits and medication she didn’t take before. She said that was a once in a lifetime situation but admitted there might be other unexpected medical situations that can come up without warning.

She was concerned about the lack of COVERAGE if she used a doctor or hospital that was not in the network. Sharon does like to travel to see her grandkids so not having her coverage follow her was a concern.

But the agent explaining all this was such a nice man and he gave her pens, a calendar, a coffee mug and other nice gifts.

At least he didn’t give her a Trojan horse …………

 

How does the Piedmont Wellstar Medicare Advantage plan work?

As the nice man explained the doctor copay’s, the ER copay’s and the daily hospital copay’s Sharon began to wonder if this Medicare Advantage plan was the right choice for her.

That was when the agent brought out the brochure for a Medicare Advantage “plus” plan to fill those gaps in coverage.  He explained that, while the Piedmont plan was one of the best ones in the state he said the Advantage plus plan will ease her mind and help her pay those bills not covered by her Piedmont plan.

The plan she was told she needed paid a daily hospital benefit, a lump sum confinement benefit. And just to be extra safe she should have the cancer benefit, DME coverage, ambulance and accidental death benefit.

This made her $0 premium Medicare Advantage plan less attractive but the nice man said she really needed it so she bought it.

For an extra $121 a month.

Who knew turning 65 could be so difficult?

 

But does Sharon need a Medicare Advantage plan with the “plus”?

If the Piedmont plan is so good, Sharon wondered why she needed to pay an extra $121 per month for the plus plan?

So she started looking around at original Medicare and a Medicare supplement plan. That’s when she found Georgia Medicare Plans and our Medigap quote engine. Our site allowed her to learn about Medigap plans at her own pace without an agent tapping his fingers on the table while waiting on her to read a brochure. Sharon also ran her own quotes and compared plans side by side.

black older womanA few days after her visit I called Sharon to see if she wanted my help. After reading through the material on our site plus some automated emails, she had a pretty good idea of the way original Medicare and a supplement plan works, but she still had a few questions.

 

Are You Getting the Full Story?

We spent about 40 minutes on the phone. Sharon had a lot of questions. She is a good listener and now has a better idea of what she thinks she wants.

The more we talked the more notes I took and it became quite clear that Sharon was moving in the right direction but had not fully explored her Medigap options.

I have access to over 170 different plans and rates vs. the 20 or less consumers can view online. I described a plan that was similar in many ways to her Piedmont Medicare Advantage plan but had several advantages over the Advantage plan.

  • She could use any doctor or hospital anywhere in the U.S.
  • She wouldn’t have to review and possibly change plans every year
  • Her out of pocket was reduced from $3900 for the Piedmont plan to less than $300 in most years

Best of all, the Medigap plan I recommended was $87 and gave her MORE coverage with LESS out of pocket than her Medicare Advantage Plus plan.

She likes the fact that she can leave Atlanta without leaving her coverage behind.

Sharon doesn’t have to review doctors and networks every year.

She likes the fact that she get’s MORE coverage for LESS money than she would have paid with the Medicare Advantage “plus” plan.

 

So why did the agent push Medicare Advantage Plus?

I don’t know exactly, but I do have a good idea.

The sales pitch was money motivated.

Instead of doing what was right by his client, the agent was being a salesman instead of an adviser.

Between the $0 premium Advantage plan and the “plus” policy, the agent was going to make about $1000 off that visit.

Don’t misunderstand me. Agents have to pay their bills but they don’t have to try and make their house payment off one sale.

Bob Vineyard has been in the health insurance business for 39 years. He makes his living the same way he always has, by educating clients on their options. And then helping them make sound decisions that deliver good value immediately and over the long haul.

Kenny Rogers said “You never count your money when you’re sitting at the table”. I never recommend any plan I would not buy for my family or recommend to a friend. And I believe you need insurance but there is no reason for you to spend all your money for a policy. Use your money wisely, make good decisions, and you will never regret it.

 

Why did Sharon drop her Medicare Advantage Plus plan?

If the plus plan was all that great Sharon might have kept what she had. But there were still gaps in coverage where she could have several hundred (or thousands) out of pocket.

The plus gap plan doesn’t pay for:

  • Hospital admissions for observation
  • Many outpatient procedures including MRI, CT scan, heart catheterization, and so forth
  • Outpatient infusion therapy (chemo) is not a covered expense

At Georgia Medicare Plans while others talk, we listen.

If you are turning 65 or you have been to this rodeo before, we believe we can help. Shop and compare!

turning 65 Medicare

#Turning65 #GeorgiaMedicareSupplementPlans #MedicareAdvantagePlans

Future of Medicare – State of the Union

Medicare cutsIn last nights State of the Union (SOTU) address, President Obama gave his vision of the future of Medicare and how to save it. Seniors turning 65 as well as those who are currently Medicare beneficiaries should pay close attention.

We have summarized opinions on SOTU and how these concepts will impact the future of Medicare.

“We’ll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn’t be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive,” the president said.

However, fiscal diets for giant entitlement programs such as Medicare and Social Security should not be so severe that they put the burden of deficit reduction mainly on seniors and the middle class “while asking nothing more from the wealthiest and most powerful,” Obama said. Earlier this week, his administration announced that it opposed the idea of raising the eligibility age of Medicare from 65 to 67 years, a measure supported by Congressional Republicans.

Medscape

This sounds great, but as we have pointed out before, when it comes to health care paying for outcomes is counter-productive. Doctors and hospitals faced with penalties or lower reimbursement based on patient results may refuse to take on chronic conditions that will never get better or the sickest patients whose likelihood of recovery is marginal.

In other words, the sickest patients may have trouble finding a doctor to treat them.

Obama continues his class warfare assault by asking the wealthiest to pay more for Medicare. There are also some in Washington that want to change Medicare supplement plans by imposing a penalty on those who have “rich” plans such as Medigap plan F. Medicare supplement rates for plan F are already higher than other plans. Asking seniors with Medicare supplement plan F to pay a penalty tax is overkill.

Most who have wealth in their senior years also enjoyed high earnings during their working years and paid more in Medicare taxes than middle and low income workers.

Medicare is already means tested.

Just check out this official website outlining the premiums for Medicare recipients. Premiums for Medicare Part B (which covers services like lab tests, surgeries and doctors’ visits) range from $99.90 to $319.60 per month and prescription drug coverage costs wealthier beneficiaries $66.40 more per month than it does for those who receive the standard benefit.

Washington Examiner

The “wealthy” pay more all around. Class warfare will not improve the Medicare balance sheet.

And yes, let’s not overlook the impact of Obamacare on the future of Medicare.

Hospices—health care facilities for the terminally ill—along with other Medicare providers are facing Medicare pay cuts. Of the $716 billion in payment reductions, hospice care was hit by a $17 billion payment cut from 2013 to 2022.

San Diego Hospice recently laid off 260 workers, closed a 24-bed hospital, and has recentlyfiled for Chapter 11 bankruptcy. San Diego Hospice’s financial condition is attributed mainly to reduced Medicare reimbursement, fewer patients, and a federal audit that hurt the center’s reputation.

Another provider, Delaware Hospice, had to lay off 52 workers, citing lower federal reimbursement as the cause. “The decision,” said CEO Susan Lloyd, “is a direct result of a consequential decline in census and the need to position the organization to meet additional changes and challenges that the hospice industry anticipates with health care reform.”

Heritage

Obamacare cuts are already having an impact on seniors, especially those who need hospice services. If you are concerned about the future of Medicare, get involved and let your representatives in Congress know how you feel.

Georgia Medicare Plans helps seniors maximize their dollars by finding the lowest Medicare supplement rates that meet your needs and budget.

Enroll in Medicare at Age 65

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

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

Turning 65?

Enroll in Medicare age 65

Enroll in Medicare Part A and Part B

Most people will choose to sing up for  Medicare Part A on their 65th birthday. If you want to enroll in Medicare Part B you will have to elect that coverage by signing up online or calling Medicare.

If you are receiving Social Security you will be automatically enrolled 3 months before your 65th birthday

You can sign up at the SSA/Medicare site, or call 1-800-MEDICARE.

When you enroll in Medicare Part B only cover a portion of your doctor and outpatient expenses will be paid by Medicare. Medicare Part B has an annual deductible you must satisfy, and then you pay 20% of expenses approved by Medicare but not paid by Medicare.

For some, this can amount to a lot of out of pocket expenses.

Check out our Medicare FAQ page

Buy a Medigap Plan

To offset your Medicare Part A and Part B expenses, most folks in Georgia will purchase a Medigap plan.

The popular Medigap plan F is what most people are sold and never told about lower premium options that deliver better value. Probably 90% of my clients purchase Medicare supplement plan G once they realize how much money they are throwing away on Medigap plan F.

Understand your Medigap options by reviewing the Medicare guide to CHOOSING A MEDIGAP POLICY.

Compare Medigap rates and plans online. Click, quote, review, compare. In addition to your online quote, a personalized proposal will be sent direct to you.

Enroll in Medicare Part B when you are first eligible to avoid any late enrollment penalties.

You should also enroll in Medicare Part D when you enroll in Medicare Part B. If you enroll in Medicare Part D late you will pay a lifetime penalty of 1% per month for every month you could have enrolled in Medicare Part D but did not enroll.

Ask us how to enroll in Medicare or how to find low cost Medigap rates.

shop and compare Medigap plans and rates

 

#EnrollInMedicareAtAge65

#Age65EnrollInMedicare

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Turning 65 – Need to Buy Medigap Insurance

Buy Medigap insurance in Georgia when you turn 65. Do you want the best rate for plan F? Georgia Medicare Plans is an excellent resource for low cost plans when you need to buy Medigap in Georgia.

U. S. News and World Reports offers 7 tips for seniors and baby boomers retiring at age 65 in 2012.

Sign up for Medicare on time. You can first enroll in Medicare during a seven-month window beginning three months before the month you turn 65. Sign up during the months leading up to your 65th birthday if you want your coverage to begin the month you turn 65. (If your birthday is on the first day of the month, your coverage can start as early as the first day of the prior month.) If you don’t sign up for Medicare Part B during this initial enrollment period, your premiums may increase by 10 percent for each 12-month period that you delay enrollment. If you are still working and covered by a group health insurance plan at work, sign up within eight months of leaving the insurance plan to avoid the penalty. Make sure you buy Medigap coverage to protect you against huge medical bills.

Schedule your free physical. Beginning this year, Medicare provides a one-time free physical exam within the first 12 months you have Part B coverage by a doctor who agrees to be paid directly by Medicare. The visit may include a review of your health, vision and blood pressure screenings, education and counseling about preventive care services covered by Medicare, and referrals for treatment you may need. Other preventative services you may be able to get at no out-of-pocket cost include cardiovascular and breast cancer screenings, bone mass measurements, and flu shots.

Delay Social Security until next year. While Medicare eligibility for 1946-born baby boomers begins this year, they still will not qualify for the full amount of Social Security benefits they are entitled to. Boomers will have to wait another year, until age 66, if they do not want their entitlement checks to be reduced. Retirees who claim Social Security this year when they turn age 65 will get about 93.3 percent of their full monthly benefit, because they will be getting payments for an additional 12 months. Social Security payouts further increase for each year boomers delay claiming up until age 70.

Develop a retirement spending strategy. Before you plunge into retirement, develop a plan for how you will spend down your assets. Recognize that you will need to pay income tax on withdrawals from traditional 401(k)s and IRAs and withdrawals from those accounts become required after age 70½. Retirees who don’t withdraw the correct amount will face a 50 percent tax penalty on the required withdrawal amount. Also, consider adding some inflation-fighting investments to your portfolio, such as Treasury Inflation-Protected Securities (TIPS), or some exposure to the stock market, commodities, or real estate. “You are probably better off trying to work a little bit longer, recover some of the losses in your retirement plan, and let the market do a little bit of the work,” says Robert Baxter, CEO of Dryden Mutual Insurance Company in Dryden, N.Y., and a 1946-born baby boomer who will turn 65 in August 2011. “If you think about retirement at 65, you may end up living 20 or 25 more years and could outlive your income.”

Keep your job skills sharp. Baby boomers who haven’t saved enough to retire may need to spend several more years in the workforce. Make sure you stay on top of training and computer skills and continue to pursue new projects and opportunities at work. You don’t want to get pushed out of the workforce before you are a ready to retire. Also consider offering to mentor younger employees and pass along your skills to upcoming workers within your organization. “We have all of this great experience and knowledge in a lot of different industries and everyone is going to retire and we’re not passing it on to anyone,” says Andrew Seybold, a 1946-born baby boomer in Santa Barbara, Calif., who runs his own mobile wireless industry consulting business. “I think we owe it to people following us to try to pass some of that information on to them.”

Negotiate a new work schedule. Instead of retiring completely, many baby boomers are interested in working a more flexible and less demanding schedule. When asked about the life changes they have planned for the next few years, more than half (55 percent) of employed baby boomers turning 65 this year say they are interested in cutting back on their work hours, according to a recent AARP survey of 801 adults born in 1946. And about 15 percent of the retired baby boomers plan to go back to work. “People are going to use the guise of retirement to get a break, rest up, and essentially get ready for a new phase of life,” says Marc Freedman, founder and CEO of Civic Ventures and author of the upcoming book The Big Shift: Navigating the New Stage between Midlife and Old Age. “Retirement is becoming a transition, rather than a destination. True retirement is going to get deferred to much later in life.”

Plan your new life. Develop a plan for the activities you would like to try next. Baby boomers turning 65 this year say their top priorities for the next few years are maintaining their physical health (84 percent) and spending time with family (81 percent), AARP found. Other popular planned retirement activities include interests and hobbies (76 percent), doing things you have always wanted to do (74 percent), and travel (61 percent). Although you may need a rest after decades in the workforce, eventually you will want to channel your energies and abilities into a new project.

In addition to signing up for Medicare Part A and Part B, you should buy Medigap coverage, or a Medicare Advantage plan.

Original Medicare and a Medigap plan allow you access to almost every doctor and hospital in the country. There are no networks. No referrals. You can choose any doctor (including your own). You never have to worry about your coverage when you have Medicare and a supplement plan. Many Medigap plans cover almost all of your routine medical expenses with little or nothing out of pocket.

Medicare Advantage plans have networks that require you to use THEIR doctors and hospitals. Most medical services require you to pay a deductible, copay or both out of pocket. Advantage plans are not portable. If you leave the state or even travel to another part of Georgia away from your home you may have difficulty finding a doctor or hospital that accepts your plan. Even still, you may have to pay a significant portion of your medical bills that are not fully covered by your Advantage plan.

You can find information about Georgia Medigap rates and plans, guaranteed issue, initial enrollment period and more on our site.

When you are ready to buy Medigap coverage, Georgia Medicare Plans has the best Medigap rates in the state for seniors turning age 65.

Medicare Number, Letter

My Medicare card has a 9 digit number followed by a letter. What do the letters in my Medicare number mean?Medicare supplement rates Georgia

The Social Security number followed by one of these codes is often referred to as a claim number. We assign these codes once you apply for benefits. These letter codes may appear on correspondence you receive from Social Security or on your Medicare card. They will never appear on a Social Security card.

For example, if the wage earner applying for benefits and your number is 123-45-6789, then your claim number is 123-45-6789A. This number will also be used as your Medicare claim number, once you are eligible for Medicare.

Code

Identification

A
Primary claimant (wage earner)
BAged wife, age 62 or over
B1Aged husband, age 62 or over
B2Young wife, with a child in her care
B3Aged wife, age 62 or over, second claimant
B5Young wife, with a child in her care, second claimant
B6Divorced wife, age 62 or over
BYYoung husband, with a child in his care
C1-C9Child – Includes minor, student or disabled child
DAged Widow, age 60 or over
D1Aged widower, age 60 or over
D2Aged widow (2nd claimant)
D3
Aged widower (2nd claimant)
D6Surviving Divorced Wife,  age 60 or over
EWidowed Mother
E1Surviving Divorced Mother
E4Widowed Father
E5Surviving Divorced Father
F1Parent (Father)
F2Parent (Mother)
F3Stepfather
F4Stepmother
F5Adopting Father
F6Adopting Mother
HADisabled claimant (wage earner)
HBAged wife of disabled claimant, age 62 or over
MUninsured – Premium Health Insurance Benefits (Part A)
M1Uninsured – Qualified for but refused Health Insurance Benefits (Part A)
TUninsured – Entitled to HIB (Part A) under deemed or renal provisions; or Fully insured who have elected entitlement only to HIB
TAMedicare Qualified Government Employment (MQGE)
TBMQGE aged spouse
WDisabled Widow
W1Disabled Widower
W6Disabled Surviving Divorced Wife

This information provided by Social Security.

When enrolling in a Medicare supplement plan you will need your Medicare card which indicates your Medicare number and effective date(s) for Medicare Part A and Part B. There are several times when you can enroll in a Medicare supplement plan without providing evidence of insurability.

When you first turn age 65 and are enrolled in Medicare Part A and Part B, or during SEP (special enrollment periods) includine your Medicare trial right. Agents that specialize in Medicare supplement plans can advise if you are eligible to enroll on a guaranteed issue basis.

Georgia Medicare Plans has affordable Medicare supplement plans for seniors. Instant online Medigap rates for several carriers including Mutual of Omaha, Blue Cross, Humana and more.