Why Do I Need a Medicare Supplement?

Do I really need a Medicare supplement plan? You and 25 million others ask the same question. The answer is, you don’t NEED a Medigap plan but you will probably want one.

GA Medicare expert Bob Vineyard explains.

Original Medicare – Good and Bad

Original Medicare Part A, the hospital inpatient portion, does not charge a premium to most people. Other than the per admission deductible ($1364 in 2019) you will not have out of pocket expenses for most hospital stays. This applies if your hospital admission does not exceed 60 days and Medicare approves all hospital billed charges.

Charges by a surgeon or other non-staff member usually fall under Medicare Part B. The same is true for ER charges and expenses incurred when admitted for observation.

Medicare Part B is for outpatient health care charges. You are not required to enroll in Part B but you probably want to. Large claims exceeding $40,000 often have over half the total incurred on an outpatient basis.

Medicare Part B requires a premium payment. In 2019 the premium for most people is $135 per month. Part B has a yearly deductible ($185 in 2019). Above the deductible Medicare pays 80% of approved charges, you are responsible for the 20% balance.

There is no cap on your out of pocket expenses for Parts A or B.

A Medicare supplement plan will greatly reduce your out of pocket expenses for Parts A and B charges. Most buy a supplement plan for two reasons.

First, they are able to keep their doctor. No, this is not a campaign pledge. You really CAN keep your doctor(s). Also you are free to use any doctor or hospital in the U.S., penalty free.

Second, a Medigap plan allows you to budget future health care expenses. No worrying about unexpected large medical bills.

Do We Need a Medicare Supplement Plan?

Late Enrollment Penalties

The best time to enroll in Medicare is when you are first eligible. Medicare does grant a “free pass” in SOME situations when you enroll late. Make sure you understand the rules.

If you don’t qualify for no premium Part A you will incur late penalties if you fail to enroll on a timely basis.

Likewise, Medicare Part B has late penalties which can be waived in some situations. If you are charged a Part B late penalty you will pay it for life.

There are no late enrollment penalties for failure to enroll in a Medigap plan but there can be consequences. If you miss your initial enrollment or special enrollment period you will have to qualify medically for coverage. The decision is pass/fail. Either you qualify or you don’t.

How Much Does Medicare Cost?

Unless you have enjoyed “free” insurance up until now, you will probably find that original Medicare and a Medicare supplement plan are real bargains.

No provider networks. Never any non-par penalties or hidden provider charges.

You have questions. We have answers. Never any charge.

All I ask is that you allow me 10 minutes on the phone to answer your questions. If you like what you hear and believe I can help, then great.

If not, you walk away and we part as friends.

I call it an offer you can’t refuse.

#GAMedicareExpert #GAMedigapRates #GeorgiaMedicareSupplementPlans

Medicare Supplement – What If You Just Bought?

Let’s say you turned 65, enrolled in Medicare and just bought a Medicare supplement plan. Did you make the right decision? What are some of the traps and mistakes?

Please take 3 minutes to read this then decide if you need to reconsider your decision. It might just save you a lot of time, money and grief.

You are turning 65 and about to go on Medicare. Here are some things you need to know about your journey.

Medicare Supplement - Turning 65

 

About That Medicare Supplement Plan You Just Bought

You are not alone.

Roughly 80% of retirees about to turn 65 have never bought health insurance before.

My 40 years in the health insurance business was not enough to prepare me for understanding the Medicare system. It took me about a month of research and talking to Medicare specialists before the light bulb turned on.

If it was that difficult for me I can imagine how confusing it is for you and everyone else.

Medicare supplement or Medicare Advantage?

 

Your Friends May Offer the Worst Advice

Your friends that are on Medicare are probably still confused about what they have and how it works. I know this because I talk to people every day that were told something about Medicare that is 100% wrong and will prove very costly down the road.

They are probably very good at many things, but Medicare experts they are not.

Ask your friends who THEY talked to in making their decision. If they were pleased, ask for a recommendation. Then you talk with that person and decide if they are giving solid advice or simply pushing a product.

Sadly, most agents talk too much and never listen to your needs.

If they bought a $0 premium Advantage plan (along with a bunch of junk to fill the gaps), or Medigap plan F they will learn to regret that choice later down the road.

 

Things You Probably Don’t Know

When you turn 65 you have ONLY ONE Initial Enrollment Period (IEP). During that time you can purchase ANY PLAN from ANY CARRIER without answering health questions. Your initial enrollment for Medigap begins the month when you turn 65 AND go on Medicare Part B. It ends 6 months later.

During your IEP you can freely change Medigap plans within the same carrier or move from one carrier to another without penalty. Most people we talk to will end up paying a lot more for their coverage than was necessary. It is not too late to change. Don’t let pride stop you from making a better financial decision. (More on this later)

You have 60 days from the time you turned 65 and enrolled in Medicare Part B to pick a Part D drug plan or Medicare Advantage plan. If you wait, your next opportunity will be during the Annual Enrollment Period (AEP) and you will pay a LIFETIME late enrollment penalty.

If you bought an Advantage plan and then learned that was the wrong decision you can still purchase a suitable Medigap during your IEP. This happens with some frequency so no need to feel embarrassed.

Many of the newer Advantage plans are “front end loaded” so you pay most of the costs of your care without the benefit of a copay. The networks are also more restrictive than you may have been accustomed to with traditional health insurance.

Get instant GA Medigap quotes, then request our FREE Medicare Supplement rate report that shows ALL the Medicare supplement rates.

 

Discovering What You Bought

Medigap “gotcha’s”

Medigap is simple, but not as simple as some might think. Sure, the plans are standardized. All plans with the same letter (plan F for example) are identical in every way except the price you pay.

But the simplicity stops there.

Financial ratings don’t matter. “A” rated carriers like AFLAC and Omaha have sucker punched retirees in the past. Offer a low going in rate then substantial increases in later years. Sometimes they stop writing new business with that carrier name.

Then what happens?

Look for LONG TERM STABILITY in the Medicare supplement market. If a carrier doesn’t have at least 5 years in the Medigap market operating under the SAME NAME, you probably want to cross them off your list.

The carrier names are interchangeable and every 3 – 4 years an old carrier will be swapped for a newer one that has rates 20 – 30% below the “old” carrier. The new, lower rates are only for NEW APPLICANTS.

Some carriers have “hot” rates in Georgia right now. But none of them have more than 2 years in the Medigap business an at least one has already had a 9% rate increase.

 

Which Carrier Did I Pick for My Own Coverage?

My choice

You don’t have to do what I do but consider this. I have more experience in the health insurance business than anyone you have talked to so far. There are some paths I won’t take because I know the pitfalls. Maybe you should do the same.

I enrolled in Medicare in September 2015. How many agents have you talked to so far that are also on Medicare?

My guess is none.

I didn’t buy a plan from any carrier with less than 5 years in the Medigap business.

I didn’t buy Medicare supplement plan F.

I didn’t buy a Medicare Advantage plan. Even if I did, I certainly would NOT buy a hospital indemnity plan, a cancer plan, a heart attack plan, etc to fill the gaps. An agent that pushes those policies is all about making as much money as possible off you.

 

It’s Your Plan and Your Money

Choose wisely.

Ultimately, whatever choice you make should fit your needs and budget. I don’t expect everyone to make the same decisions I make, nor would I pressure anyone to buy something just because I am doing it. But I do believe my clients deserve to know the choices I will make and why I am making them.

There are more than 250 different Medigap plans and rates in Georgia. You probably looked at half a dozen or less. What did you miss by not seeing ALL the rates?

There are only TWO or THREE Medicare supplement carriers with competitive rates that have 5 or more years in the Medigap business. If you didn’t buy from them you probably are, or will eventually be, paying too much.

When you pay more you don’t get more. You simply paid too much.

Let me know how I can help. Call (404) 252-5859 to speak with Bob Vineyard. 

Hospital Admission – In or Out?

Original Medicare offers excellent hospital admission coverage under Medicare Part A. But how is your hospital bill treated under Part B? Are you in or out?

  • Full Part A coverage for up to 60 days following a deductible of $1364 (2019)  per hospital admission
  • Full Part A coverage for up to 100 days in a Skilled Nursing Facility (SNF)
  • Full Part A coverage for up to 100 days for home health care

Each of the above are true but only if they follow hospital admission as an INPATIENT (Medicare Part A) for at least 3 consecutive days prior to your SNF stay or home health care.hospital admission

But what if you were never admitted as an inpatient and your observation stay was covered by Medicare Part B?

What is my liability for out of pocket costs if my hospital admission was a Part B stay?

Hospital Admission – In or Out?

Consider the case of Caroline Giada.

On the morning of Sept. 23, 2014, Caroline Giada woke up in her home in coastal New Jersey. She rose from bed, walked over to the bathroom and fainted, hitting her back on the sink cabinet on the way down. When she came to, she couldn’t move. So she called 911.

The 76-year-old was taken to the emergency room, where the attending nurses looked her over and booked her into a bed. Over the next six days, she was given every kind of test imaginable: X-rays, electrocardiogram, CT scan, ultrasound, MRI. Nurses came and went. So did doctors. Finally, a week later, the problem was uncovered: a fracture in the L5 segment of Giada’s lower spine. They called in a specialist, but he said he couldn’t operate until the following Thursday.

After her surgery and rehab, when she was ready to go home, Giada was hit with another surprise: a bill. Medicare had covered the surgery and the rehab, but not the nursing facility stay, and the facility told her she owed $2,360. “I couldn’t understand it,” says Giada. “They said, ‘Well, Medicare isn’t paying, because the hospital put you under observation instead of as an inpatient.’” – America Aljazeera

Had Caroline been admitted as a hospital inpatient, her nursing facility stay would have been covered in full. Instead she was faced with a significant outpatient bill.

If You Have Medicare, Ask!

Are you considered an inpatient or outpatient?

If you don’t know, ASK!

Medicare does cover outpatient services subject to an annual deductible ($185 in 2019) and coinsurance (you pay 20%, Medicare pays 80%). Unlike traditional insurance that caps your out of pocket, you responsibility for Part B expenses have no cap.

You continue paying 20% until you are well, you run out of money, or you die.

Look what Medicare covers.

Medicare supplement plan F will pay your Part A deductible ($1364 in 2016), your Part B deductible ($185 in 2016) as well as your 20% share. With original Medicare and Medigap plan F your out of pocket for approved Medicare Part B charges is $0.

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Hospital Notification Changes

The  Notice of Observation Treatment and Implication for Care Eligibility Act was signed into law in August, 2015 and will go into effect in August, 2016.

Medicare beneficiaries in the hospital for more than 24 hours must be informed in writing of their hospital admission status within 36 hours of when they begin receiving medical services as an outpatient. The written notice must clearly explain:

  • that the individual is not an inpatient;
  • the reasons for the person’s observation status; and
  • the implications in terms of increased financial responsibility and lack of eligibility for coverage in a SNF after discharge.

The patient or their representative must sign the notice to acknowledge their understanding.

When was the last time you reviewed your Medicare supplement plan? Get a free instant Georgia Medigap quote. No obligation.

We will also send you a Medigap Transparency Report showing rates for all Medicare supplement carriers in your area. Most quote engines, including ours, only show a few plans. But there are more than 40 carriers offering Medigap plans in Georgia. See which ones have the best rates!

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#GAMedigapRates  #HospitalAdmission #MedicarePartB

How to Find the Right Medicare Plan

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Scroll down for UPDATE

 

Do you want to know the secret of how to find the right Medicare plan when you turn 65? Medicare supplement plan F or a $0 premium Medicare Advantage plan? What’s the big deal if you can change plans every year? How can the insurance company offer a free Medicare plan? What’s the catch? Is there something the insurance agent isn’t telling me? Why not cut out the middle man (the agent) and just buy direct?which-medigap-is-best2

If you are turning 65 and aging in to Medicare you have more questions than answers. And there are probably questions you never thought to ask ………. until it is too late.

If you already decided on a Medigap plan you might want to check the rate. There are more than 170 Medicare supplement different plans in Georgia but most don’t illustrate their premiums online.

Shop and compare GA Medigap quotes.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

Find the RIGHT Medicare Plan

Georgia has more than 170 different Medicare supplement insurance plans, more than 45 drug plans and about 25 different Medicare Advantage plans. How can you possibly find what you need to know and make the right decision the first time?

Compared to Medicare Part D, and Advantage plans, picking a Medigap plan is a piece of cake. That doesn’t mean it is easy, just easier.

If you have the right information.

The information a consumer really needs is not available to the public.

You won’t find it on Medicare.gov.

You won’t find it on the Georgia Dept of Insurance site.

You won’t find it on public forums.

You won’t find it on sites with “instant Medigap quotes” ……………. including mine.

Where will you find the information you need to make an informed decision and choose the right Medicare plan for your needs and budget.

Pick up the phone and call. I will answer all your questions and give you rates by phone and email a comparison.

Call 404 907 0925.

 

You can also start the discussion by email or securing a Medigap quote through my site.

 

 

Susan is turning 65 and wants a Medicare supplement plan

A short time ago, Susan visited my site.

Twice.

Medicare changesThe first time she entered her information for a quote she was a non-smoker. The second time she was a smoker.

Both times she listed a valid email address.

Both times she gave a bogus phone number.

I know because I called and the number was disconnected.

No problem. I know some people don’t like to talk on the phone.

Since I didn’t have a valid phone number I sent an email asking if she used tobacco or not. Rates are higher for tobacco users with most carriers, so I wanted to give her accurate rates.

I also have access to over 170 different plans and rates. Most of them are not shown online anywhere.

They are not on Medicare.gov

They are not illustrated on carrier sites.

They do not appear on agent sites, including mine.

This isn’t a plot. Some carriers don’t want their rates made public.

Susan responded to my email. Here is what she had to say.

The first entry was a mistake.  I didn’t realize that non-tobacco was checked.  I am still a tobacco (cigarette) user but I have cut my smoking down to about 5 cigarettes or less a day, using e-cigarettes. (Comment: for rating purposes she will be considered a smoker with MOST carriers)

I don’t really have any questions.  I won’t be 65 until November so I have plenty of time to search online for the best rates. (Comment: Yes, she does have time. Will she find the best rates online? No).

I’ll probably go with Plan G if the difference in a year’s premiums between it and Plan F is more than $147, and I’m sure it will be. (Comment: Plan N might be an even better choice)

The last thing I want is a long, drawn out conversation on the phone with someone attempting to explain things I always know. (Comment: That’s the last thing I want too).

I’m just simply looking for the best rates for Plan G or Plan F.  I’m familiar with Medicare and how it works.  My husband is already on Medicare.  I much prefer to search online and actually read article than have someone attempt to explain anything to me.  I will let you know if I do have further questions.

My response was simply to provide the best rates based on her data and wish her well.

I don’t know if she believes she can game the system and get a non-tobacco rate or not. That is not my concern since I closed her file.

I did quote non-tobacco rates, using a carrier that does not assess tobacco loads if you buy when you first turn 65 and go on Part B. The rates are accurate and lower than anything Susan can find online.

Based on her age, tobacco use and zip code she will probably pay at least $150 more per year than she needs to and that is just the first year. The carrier with the next best tobacco rate has a history of dealing higher than normal rate increases.

Medicare.gov is a great place to go if you want information on ALL the Advantage plans in your area, and ALL the Part D drug plans. In fact, I tell prospective clients to buy Advantage plans or drug plans by calling 1-800-MEDICARE.

But if they want accurate information on all the available Medigap plans in Georgia, they should talk to me. I have more information on Medicare supplement insurance carriers than Medicare does. And if you ever have a question AFTER you buy, give me a call.

You will get me or my voice mail.

You will never hear “Press 1 for English”.

 

UPDATE

A few weeks later I got another email from Susan, our online shopper that didn’t want to talk to anyone. She told me the best rates she could find for plan G were $115 from Aetna and $118 through Omaha. She wanted to know if these rates were good.

She completely ignored my email from a week earlier giving her a rate of $106 for plan G.

My response, “The rates are good. Pick the one you want”.

 

 

Medicare supplement or Medicare Advantage?

Which is the right Medicare plan for you?

That is something you need to decide once you have the facts and understand your options. My job is to educate you so that you have enough information to make the right choice based on your needs and budget.

I won’t tell you what to buy.

You will never be pressured into buying anything at any time.find medicare information

There is no charge for my advice. The carriers pay me when I assist you in finding the right plan based on your needs and budget.

Give me 5 minutes on the phone and decide if I can be helpful or not. That’s all I ask of anyone.

If you like what you hear, great. If not, no problem. Move on and I will close your file.

The rates and plans I show you are identical in every way to those you can get direct from carriers.

The difference is, you get the benefit of my 40 years in the health insurance business at no additional charge.

Call the carrier or 1-800-INSURANCE and you never know who will answer the phone or how much they know about Medicare.

Before you go any further, I suggest the following links.

The Secret Life of Medicare Advantage Plans

Don’t Buy a Medicare Drug Plan

Those two posts should answer many of your questions and put you on the track to finding the RIGHT Medicare plan.

You might also want to shop and compare GA Medigap quotes. Click the image below for an instant quote. No gimmicks.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

 

#Turning65Medicare #ChoosingTheRightMedicarePlan  #MedicareSupplementInsurance