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 $1288 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 ($166 in 2016) 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 ($1288 in 2016), your Part B deductible ($166 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

Do I Need an Insurance Agent?

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

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

You have questions. We have answers.

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

Have you ever seen a Medigap rate report like this?

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

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

 

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

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

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

My response is always the same.

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

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

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

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

 

Where can I see all the Medigap plans?

You can’t.

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

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

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

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

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

 

Bill and Brenda went Medicare shopping

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

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

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

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

Only one problem.

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

 

How Much Can You Really Save?

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

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

The savings didn’t stop there.

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

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

$17 for 175 tablets.

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

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

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

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

 

Do you need an insurance agent?

Not really.

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

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

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

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

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

Shop and compare now.

Your information is NEVER sold.

 

 

#MedicareSupplementInsurance #InsuranceAgent #GAMedigapQuotes

Medicare Supplement Rates Trend Lower

Medicare supplement rates still increase every year but the increases are trending lower. Double digit renewals have declined medicare supplement rate increasessince 2010. Rate changes on new business have also declined to the 5% range. Prior to 2012 Medigap rate adjustments of 10% to 15% or more were common, especially for the “big name” carriers.

Georgia Medicare Plans continues to monitor rate changes for new and existing Medigap carriers and will always recommend carriers with a stable rate history.

CSG Actuarial is reporting that the trend of lower rate increases in the Medicare Supplement market has continued throughout 2014. The average new business rate increase implemented to date in 2014 is 4.3%, down from 5.0% in 2013, 7.1% in 2012, 8.4% in 2011 and 9.5% in 2010. CSG Actuarial believes these lower rate increases continue to be the result of lower claim trends in the Medicare Supplement market, due primarily to lower medical trends in Medicare and limited increases of the Part B deductible over the past few years. – CSG Actuarial

 

Five things you may not know about Medicare supplement rates

When you are shopping for a Medicare supplement plan there are at least 5 things most agents and carriers will not tell you.

  • Plan F Medicare supplement rates are overpriced
  • Which carriers are new to the market
  • The real savings is in picking the right Medicare Part D
  • The Medicare Advantage trap
  • How to lock in the lowest Medicare supplement rates year after year

Most agents and carriers promote Medicare supplement plan F. Why?plan f

It is the easiest to explain and understand.

Plan F has the highest rates and generates the most commission.

We have hundreds of Medicare clients yet probably fewer than a dozen bought Medigap plan F.

Medigap carriers come and go. Which one is best for you?

AFLAC jumped into the market in 2012 with low rates and high commissions. Barely 15 months later they bailed out leaving behind customers wondering what would happen next.

Since 2010 Georgia retirees have purchased plans from Mutual of Omaha companies named United World, United of Omaha and more recently Omaha Insurance company. Every time Mutual introduced a new carrier new applicants got lower, more favorable rates while existing policyholders paid rates that were 20 – 30% higher.

We have several carriers with stable rate histories that consistently beat Mutual rates and have never had a double digit rate increase.

Georgia Medicare Plans specializes in finding the best value and low Medicare supplement rates. Our clients save an average of $550 per year without sacrificing coverage.

 

Medicare Part D savings

The real savings comes in matching your Part D drug plan to your needs and budget.

Most people shop drug plans based on the monthly premium. Big mistake.

Medicare changesWe recently talked to a lady that was convinced the Humana Medicare Advantage plan was the best value for her. An agent came to her home laid out fancy brochures and carefully explained the merits of this PPO plan.

But the agent failed to run a drug report. Instead, the agent looked over her list of med’s (4 pages worth) and said all your drugs are generic except the insulin, your medications are all covered.

This explanation was not even close. The agent also failed to mention that 3 of the drugs were not covered on the Humana formulary and 7 of the drugs were tier 3 or higher.

Her projected drug costs for the year were $8800 under the proposed Humana plan.

We actually took the time to input each medication and generate a report.  Only two of her drugs were not on the formulary and 4 were tier 3 or higher.

The monthly premium was $56 higher but the annual cost of medications was $5900. The slightly higher monthly premium saves $2900 per year in drug costs!

 

Medicare Advantage trap

Medicare Advantage plans are promoted as the greatest thing since sliced bread but there are hidden traps that can rob a retiree of their life savings.

  • Advantage plans have networks that can change in a whim
  • Many Advantage plans only last 2 – 3 years before they are cancelled
  • Most retirees fail to read and understand the ANOC that arrives each September
  • Your out of pocket limit only includes in network approved charges
  • The Medicare allowed out of pocket limit increases almost every year

Don’t get lured into low premiums and ignore the real cost of these plans which is the cost of health care.

 

How to lock in low Medicare supplement rates year after year

Most Medigap plans in Georgia are issue age rated. If you buy your plan at age 65 your rates will never increase just because you had another birthday. When you are 70 years old if you kept the plan you bought at age 65 you are still rated as if you have never aged. Just like Dorian Gray, you never age.

Medicare supplement rates are trending lower. With over 170 different plans to pick from how do you find the one that is right for you? With our help you will never go wrong.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

Georgia Medicare Facebook Feed

Gainesville Medigap Rates

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

Gainesville is the county seat for Hall county with a population of 35,000 people

Gainesville is known as the poultry capital of the world.

Major employers in the area include Northeast Georgia Medical Center, Fieldale Farms, Pilgrims, Mar-Jac, William Wrigley Company and Walmart.

Prominent people from Gainesville include Tommy Armour (pro golfer), Brantley Gilbert (singer) and Chan Gailey (coach).

 

Gainesville Medigap Rates

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

Medicare supplement rates for a female, age 65, non-tobacco range from $127 to $250 per month. Male rates and tobacco rates are slightly higher.

Click here to review Gainesville GA Medigap rates.

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

There are currently 185 different Medigap plans available to Gainesville, Georgia retirees but only 9 Medicare Advantage plans. If you have a Medicare supplement plan you have 30 different Part D drug plans available to you.

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

 

Medigap plans for people with medical conditions

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

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

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

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

No other carrier does this!

 

Gainesville Medicare Advantage

Of the 9 Advantage plans in Hall county, three have $0 premiums, the others range from $19 to $139.

One Advantage plan is an HMO the other 8 are PPO plans.

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

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

 

Gainesville providers

There are 941 doctors in Hall county that will accept ANY Medicare supplement plan. On average, about half that number will take patients with a Medicare Advantage plan. Of the doctors that do take Advantage plan patients you will find that most accept only a few plans and almost no one participates in all Advantage plan networks.

Hall county has 35 hospitals and every one of them will take Medicare and your Medigap plan. If you pick an Advantage plan, check to see which hospitals are in network.

Shop Gainesville Medigap rates now.

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#GainesvilleMedigapRates

 

AT&T Retiree Health Insurance Plan Cancelled

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AT&T retiree health insurance plans will be cancelled for 2015 and later. What are your options? How will you pay for your coverage? Are you required to use Aon? Should you go outside the Aon “umbrella”? 2013 Medicare open enrollment

Big companies are dropping retiree health insurance plans faster than a hot potato and AT&T retiree’s are no different. You join the ranks of Alcoa, PepsiCo, IBM, Fannie Mae, Savannah River Project and many more.

So where do you go from here? Should you buy one of the suggested plans from Aon? Or should you look for coverage in the open market?

 

Aon and the AT&T retiree

Aon is a large employee benefit conglomerate that has secured a contract with AT&T to provide “counseling” services to retirees. You have probably received your notice from AT&T and may have had a call from a counselor that want’s to schedule a phone interview.

Retiree’s that contacted us for advice have indicated their counselor seems to have very little understanding of how Medicare works and what your options. The advice seems to be little more than reading from a prepared script on a computer screen.

One recent comment from a forum ……..

I am an AT&T retiree. My wife and I have been exposed to Aon’s “customer service,” which is a joke, and not a funny one. We are SO grateful to have found this forum and at least feel that we have better options than Aon offers. Thanks to all for the great information — we are truly grateful.

Aon call center reps earn around $18/hour plus a bonus for each application submitted. They are paid to push product, nothing more. Their training is specific but they would not even qualify as a “30 day wonder”.

The Aon website is of limited value, even if you know what you are doing. This is not necessarily my opinion. I am merely repeating what AT&T retiree’s have told me. Product offerings are limited, and often pricey.

Shop and compare GA Medigap Quotes

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HRA money

AT&T has agreed to deposit $2700 into the retiree’s HRA account + an additional $1500 for a qualified spouse of the retiree.

The money comes with strings attached.

stopIn order to receive the funds, the AT&T retiree (or their spouse) must purchase at least one plan from Aon. You may elect for a Medicare Advantage plan, Medicare supplement plan, or Part D prescription drug plan.

If you don’t like the Medigap options you are free to purchase your coverage outside of Aon by using an agent of your choice or going direct to a carrier. If you purchase outside of Aon the premium payment can be reimbursed by the HRA administrator.

We have found that plans promoted by Aon reps may not be in the best interest of the retiree. Whether this is intentional or simply due to a lack of understanding about how Medicare works is subject to debate.

Every AT&T retiree we have talked with have said the number of plans listed on the site is very limited and mostly seem to be higher priced offerings.

If you are looking for coverage outside of the Aon offerings, in Georgia you will find

  • As many as 20 different Medicare Advantage plans (depending on your zip and county)
  • Over 30 different drug plans (based on your county and zip)
  • Over 30 Medigap carriers offering over 170 different plans state wide

Navigating this maze of 200+ choices can be frustrating. Finding an agent that specializes in Medicare options and understands the AT&T retiree choices can be difficult.

Shameless plug follows ……….

Bob Vineyard at Georgia Medicare Plans has 40 years experience in the health insurance field. As an independent broker, he is able to offer you multiple solutions and answer all your questions. Call or email. You have questions, we have answers. You can also begin your shopping with our Medigap quote engine. Compare plans and rates side by side. Click for your instant quote.

 

 

 UPDATE: Discussions with AT&T retirees shows an alarming trend. When retirees compare rates for Medigap plan “X” with the EXACT SAME PLAN outside of the exchange the non-Aon rates are higher than open market rates.

Also, retirees are being told by the Aon reps they must buy ALL coverage through Aon to receive the HRA funds. If you are told that, ask to speak to a manager. The AT&T FAQ clearly states you must buy either Medicare Advantage, Medigap or drug plan.

 

Medicare Advantage

Medicare Advantage plans are essentially Medicare where your claims and benefits are managed by an insurance carrier instead of original Medicare.

Original Medicare does not have networks. You are free to use any doctor, lab or hospital that accepts Medicare assignment. That covers 96% of medical grammarly never make same mistakeproviders in the U.S.

Medicare Advantage is a managed care system. Some plans have very limited networks and severe penalties for using a non-par provider. These are HMO plans.

The next most common option is the PPO where you have a broader choice of physicians but is typically a much smaller number than the entire population of doctors in your area. Doctors can be dropped from the plan at any time.

 

Vera Brown of Augusta is still upset about a letter she received from her health insurer.

UnitedHealthcare wrote to notify her that it was dropping Dr. Sean Lynch, her physician, from its Medicare Advantage doctor network.

“I’ve been with Dr. Lynch for years,’’ says Brown, 67, a registered nurse. “He treats me like his mother.”

Georgia Health News

A new wave of physicians are being cut from UnitedHealth Group’s Medicare Advantage network, continuing a trend that started last year and has reportedly already shaved more than 30,000 physicians from the same network.

UnitedHealth started notifying physicians who are being terminated from the network over the last few weeks, according to state medical associations in states such as Alabama, Georgia, Massachusetts, North Carolina and Tennessee.

Medical Economics

 

When you choose a Medicare Advantage plan you must review your plan every year, usually during open enrollment. Premiums will change from year to year, benefit changes include higher deductible’s, copay’s and out of pocket limits (OOP).

Five years ago the average OOP limit for Advantage plans was $2900. Now it is $5400.

Even though your premiums may not increase your cost sharing will go up every year. Too many retiree’s make the mistake of focusing on the monthly premium and fail to account for the total cost of the plan which includes your deductibles, copay’s and coinsurance.

Your OOP limit only applies to in network APPROVED claims and does not include your prescription drug expenditures.

 

Medicare supplement coverage

Medicare supplement plans, also called Medigap insurance, is designed to work exclusively with original Medicare.

FB Groucho Marx3Any doctor, lab or hospital that participates in Medicare will also accept your Medigap coverage. They don’t care if you have a Medigap plan or the name of the carrier.

Contrast that with Medicare Advantage where you pick your doctor from a list of approved providers. If the doctor of your choice is not on the plan you can expect to pay out of pocket up to the Medicare approved amount.

Medicare supplement plans are standardized. The benefit structure is designed by Medicare. Page 9 of “Choosing a Medigap Policy” has this to say.

Every Medigap policy must follow federal and state laws designed to
protect you, and the policy must be clearly identified as “Medicare
Supplement Insurance.” Medigap insurance companies in most
states can only sell you a “standardized” Medigap policy identified by
letters A through N. Each standardized Medigap policy must offer
the same basic benefits, no matter which insurance company sells it.
Cost is usually the only difference between Medigap policies with
the same letter sold by different insurance companies.

 

All Medigap plans with the same letter have exactly the same benefits. The only difference is the premium.

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

The most popular plan if Medigap plan F followed by plan G and N.

Consider plans that deliver the most value and have a stable rate history. We suggest limiting your choices to carriers that have at least a 5 year track record of writing Medigap plans in your state.

 

Caveats and considerations

The HRA monies offered to AT&T retiree’s can change at any time. AT&T made a business decision to drop the current retiree medical plan in favor of the retiree HRA option. Only AT&T can say if they will continue this practice or not. Future deposits to your HRA are not guaranteed.

You must follow the rules in order to receive the HRA monies, but you are not required to buy all your coverage from Aon.

Outside of Aon you have more choices, but with over 200 options you may find it overwhelming.

Consider contacting an agent that is familiar with plans in your area. A knowledgeable agent can save you a lot of time, money and frustration. My clients tell me they learn more in a 15 minute phone conversation than they have learned through weeks of searching on the internet. bob on fb

Most agents will offer advice at no charge. They have access to the same plans you would have if you went direct to the carriers. Premium rates are exactly the same as you would be charged by the carrier. Agent service fees are “hard wired” into the pricing of each plan so you will not pay more for using an agent.

Offering advice, helping you find a plan that fits your needs and budget is how we earn our living. This is not a hobby. This is our livelihood.

That’s me on the right. >>>>

If you feel that a Medicare Advantage plan is best for you and you want to keep the HRA money, you must buy from Aon. Buying an Advantage plan from an agent means you forfeit the HRA deposit.

Advantage plans come with one additional caveat.

If you start out with an Advantage plan and later decide you should have picked a Medigap plan you may be able to qualify now, but not in the future.

However you can buy a Medicare supplement plan through an agent and in most cases, the carrier will pay a service fee to the agent for assisting you.

Some AT&T retiree’s may be able to qualify medically for a supplement plan. If this is the case with you, there are more plans to pick from at more favorable pricing.

If you are exercising your right to a Medigap plan under the Medicare guaranteed issue provisions you plan choices are limited, premiums are often higher and your agent most likely will not be compensated for these plans.

As an AT&T retiree you have a lot of factors to consider in making your decision. Choose wisely. Are you ready to shop and compare?

 

#AT&Tretireehealthinsurance

 

Medicare Annual Enrollment – Finding the Best Value

Every year during the Medicare annual enrollment we have calls and visitors to Georgia Medicare Plans that are looking for ways to save money. Living on a fixed income is plenty enough reason to make sure you have the best value in your Medicare plan. medicare annual open enrollment

What are P.A.R.E. claims and why should you be concerned? Who are the hidden providers? What are Medicare excess charges?

 

Many retiree’s are disillusioned with their Medicare Advantage plan and want to return to original Medicare during open enrollment. Some have seen their Medigap plan F premiums rise to the point they are no longer affordable and are considering a reduced benefit plan such as A, D, K, L, N or Hi F.

What is the best solution that fits your needs and budget? With more than 170 different plans to consider, how do you shop and compare to find the best plan for you?

 

Medicare annual enrollment

The Medicare annual election period begins October 15th and ends December 7th. During that time you can change your drug plan or Medicare Advantage plan. Many people will make that change whether they like it or not.

When their ANOC (annual notice of change) arrives they discover their PDP (prescription drug plan) will not be offered next year. Or their monthly premium is increasing. More often, the premium remains about the same but the cost sharing increases in the form of a deductible or higher copay’s via formulary shift.

Medicare Advantage cutsDuring Medicare annual enrollment many Advantage plans also come with surprises. Doctors that were in your network this year will not be in network next year. Your premium is increasing, deductibles and copay’s are higher.

And then there are those out of pocket costs.

Most people only look at their Advantage plan in terms of their monthly outlay and fail to plan for the unexpected when they are faced with medical bills in the thousands of dollars. Take advantage of this annual enrollment time to review all aspects of your plan.

Medicare Advantage plans, unlike traditional Medicare, are required to limit out-of-pocket costs for services covered under Parts A and B ($3,400 is recommended; $6,700 is the maximum). Between 2013 and 2014, the share of Medicare Advantage enrollees in plans with limits above $5,000 almost doubled, from 24 percent in 2013 to 44 percent in 2014.

KFF

This “out of pocket creep” is a common tool of Advantage plans. You are lulled into a false sense of security with the low monthly premiums and fail to consider how much your plan REALLY costs.

Your out of pocket maximum is only for IN NETWORK APPROVED CLAIMS.

What is NOT included in your out of pocket cap?

  • unapproved claims by your doctor, lab, hospital, etc
  • prescription drug costs, including your donut hole
  • claims incurred with non-participating providers

 

Hidden providers

Non-participating, hidden providers have been around for years but are something rarely discussed. senior-scratching-head

Hidden providers most often crop up in P.A.R.E. claims. You will find literally hundreds of medical providers in any area that do not participate in ANY managed care plan, and even more so with Advantage plans.

What does P.A.R.E. stand for?

  • Pathology
  • Anesthesiology
  • Radiology
  • Emergency

Non-par claims, especially in these areas, are quite common. These are providers that opt out of all networks so they can bill you in excess of the Medicare allowed charges. It is not unusual for these providers bills to exceed the Medicare allowance by hundreds or thousands of dollars!

And those claims are EXCLUDED from your Advantage plans out of pocket cap.

 

Original Medicare

When Medicare was created in 1965 beneficiaries were free to use any doctor, lab or hospital, anywhere in the United States.

There were no networks. No participating or non-participating providers. No penalties for using the “wrong” doctor.

dr lundellYou had complete freedom to pick a doctor that is right for your needs rather than choosing from a list of approved providers. Medicare annual enrollment did not exist.

You went on Medicare at age 65 and kept it for life. Annual enrollment was a foreign term and life was simple.

Original Medicare had almost no moving parts and the only real financial exposure was in the form of deductibles and coinsurance. Medicare then, and now, have NO CAPS on your annual out of pocket.

Your Medicare Part A hospital deductible is currently $1216 ……….. per benefit period (per admission). That may not be so bad unless you are like a former client.

Roy had the misfortune of being admitted to the hospital 5 times in the year he died.

That’s a lot of exposure.

Roy also had numerous doctor visits, MRI’s, lab work and chemotherapy. Those fall under Medicare Part B where you pay the annual deductible (currently $147) and then the remaining 20% of what Medicare does NOT pay.

Roy also had a Medicare supplement plan that paid 100% of approved Medicare claims.

Electronic imaging, the “R” in P.A.R.E. claims, can easily run over $1000 per event.

Modern chemotherapy is normally performed in an outpatient (Part B) setting. Some chemo drips run $5,000 or more.

How does a retiree, living on a fixed income, protect themselves from financial ruin?

With a Medigap plan. Shop and compare plans.

 

Medicare Supplement Plans

Shortly after Medicare was “invented” insurance carriers realized the financial risk involved and presented a way for seniors to protect their life savings by purchasing a policy called “gap” insurance. The common name is Medigap, although that term is interchanged with Medicare supplement in much the same way as Kleenex and tissue are synonymous.

Medicare-quote-front-CW-300x200

In 2006 Medigap plans were standardized and assigned letters. Each plan with the same letter was identical in every way ………. except the monthly premium.

Paying more for your Medicare supplement plan doesn’t get you a better plan, it simply means you paid too much.

Currently the Medigap plan F is the most popular ……… and the most over-sold plan. It almost always fails to deliver on value. Occasionally a new carrier will come along and under-price their plan, intentionally or otherwise, to capture market share. Almost invariably with a year or two that plan is becoming prohibitively expensive.

Retiree’s on plan F will use the Medicare annual enrollment period to shop for plans looking for a better value.

Georgia has 11 approved Medigap plan designs offered through over 30 different companies. The result is more than 170 different plans and rates to sort through.

A wise shopper will quickly discard 8 of the plans as either being over-priced for the design or lacking in value.

At Georgia Medicare Plans we encourage our clients to focus on 3 plans and eliminate carriers that have not offered Medigap plans for at least 5 years. This approach clears out the clutter by casting aside low value plans and narrows the field of carriers to only a handful.

Removing carriers that lack a proven track record in the Medigap supplement arena eliminates 10 carriers from consideration. Using data from CSG Actuarial, this includes companies including GPM, Heartland National, Gerber, Bankers Fidelity Assurance, as well as newcomers such as Omaha Insurance Company, Manhattan Life, Companion Life, and American Retirement Life.

Focusing on value, eliminating carriers that may be here today and gone tomorrow (like AFLAC), and observing renewal rate action we can help our clients find a plan that fits their needs and budget year in and year out.

 

Our service is valuable but you pay nothing

Bob Vineyard has almost 40 years in the health insurance industry. His expertise is available to you at no charge.

Georgia Medicare Plans has access to over 170 plans and rates you will not see on any website. Most agents will only show you a few plans from one or two carriers.

When you call a company or marketing organization (such as AARP) you will only be told about plans THEY offer. If you want to compare their plans to the competition you will have to call another company and listen to their sales pitch about THEIR products.

Once you have all that you may have fewer than a dozen plans from 4 or 5 carriers and then YOU have to decide on your own which plan is best for you.

Medicare supplement costWe give you the opportunity to view as many plans as you want, take the time to explain the benefits of one plan over another, advise you on rate history, who is brand new and who has been around for a while.

We can do this in 15 minutes or less by phone and email.

Finding a plan that fits your needs and budget starts with a brief phone call so we can learn what is important to you.

For some it is the ability to choose their own doctor, and keep ones they have now. Some want full coverage while others are willing to participate in cost sharing in exchange for premium savings.

Even then, the cost sharing is minimal and significantly less than the thousands of dollars you may need to spend every year with an Advantage plan.

From there we can recommend plans that will work for you and let you decide.

During this years annual enrollment what do you want? You can spend weeks online, searching, and dealing with endless phone calls. You can have a parade of agents in your home or you can attend “information meetings”.

We allow you to shop from the comfort of your home. Our site allows you to run your own quotes and compare plans side by side. When we receive your information an email will go out with the subject line “Medigap rates you won’t see anywhere else“.

In the body of the email, in bold print, are rates for our most popular plan based on your age and zip code.

We also follow up with a phone call to make sure you received the email and answer any questions.

No pressure. No in home visit. This is your opportunity to ask questions and get straight answers.

Don’t walk away. Shop and compare now.

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