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. 

Why Are Georgia Medigap Rates So High?

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

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

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

Why is this? What is the answer?

The simple answer is, do your homework before buying.

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

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

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

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

 

What’s up with Georgia Medigap rates?

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

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

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

Corny, but effective.

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

 

Georgia Medigap rate changes

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

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

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

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

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

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

 

 

Buying a Medigap plan when turning 65

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

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

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

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

 

Why limit yourself to one Medigap carrier?

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

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

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

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#GeorgiaMedigapRates  #MedicareSupplementRateIncreases  #GAMedigapRates #2017MedicareSupplementRates

Does Medicare Work Anywhere?

Does Medicare work anywhere I live or go? If I travel to another state, will my Medicare coverage still pay my bills? Can I see any doctor and Medicare will still pay?

Will Medicare work wherever you are? Will it be there for you when you need it most?married couple hospital bed

  • Never any networks, you can travel anywhere in the US and still have coverage
  • Medicare works with any hospital, doctor or lab in the United States
  • Medicare follows you when you move to a new city or state

Because Medicare supplement plans go hand in hand with original Medicare, you will never have a gap in coverage when you travel or relocate to a different city.

Paying too much for your Medigap plan? Use our online instant Medigap quote engine to find the best rates based on your age, gender and zip.

shop and compare GA Medigap quotes

There is nothing like original Medicare for peace of mind, especially when you move. Medicare can work anywhere.

What follows is a true story. Events actually happened. Only the names have been changed.

 

Does Medicare work anywhere in the US?

Fred and Ethel had been married for years. Like most couples, they had their spats but they always made up and deep down inside they truly loved each other.

Fred had a heart condition that required him to see a specialist several times a year. Ethyl was a nurse for many years before retiring due to health issues and she took good care of Fred. As they aged they realized they wanted to be closer to their daughter Lucy in Atlanta, so they made plans to sell their house and relocate.

Lucy loved her parents and so did her husband Ricky. Their children were grown and they agreed to invite Fred and Ethyl to move in with them.

And so it began.

 

Fred had a heart attack

Fred and Ethyl sold their home in Louisiana and moved to Georgia to live with Lucy and Ricky. The move went smoothly but not without incident.

Soon after moving Fred had a heart attack and was taken by ambulance to Northside Hospital. After being stabilized in the ER Fred was admitted to the coronary care unit where he could be monitored 24 hours. A few days later he was moved to a private room so his care could be continued until he was well enough to be discharged.

Will Medicare work anywhere?

Medicare covers emergency room, hospital ICU, doctors, scans, and inpatient lab work in full subject to a $1288 deductible (2016). For the next 60 days following admission Medicare will pay 100% of your medical bills.

Fred was ready for discharge but the doctors wanted him to spend a few days in a rehab facility before going home where he would need periodic home health care.

Medicare works anywhere. In the hospital, in rehab, at home.

 

But Fred and Ethyl didn’t have Medicare

Medicare can work anywhere, but Medicare Advantage is a different animal.

In order to save money they enrolled in a $0 premium Medicare Advantage HMO plan. What they saved in premiums they paid out in health care expenses between doctor trips and hospital visits while living in Louisiana. As Fred’s health declined their out of pocket costs grew to several thousand dollars each year.

married couple walking from storeMedicare HMO plans offer coverage for in network care and emergency care out of network. But you have no coverage for out of network treatment when it is not a medical emergency.

Lucy was helping her parents with the move so she called their insurance carrier to find out what needed to be done to continue coverage. She was told their current plan would be good for 60 days. Once they relocate to Georgia they will need to notify Social Security of their new address and secure new coverage.

But things didn’t go as smoothly as expected.

Fred’s emergency admission to the hospital was covered by his HMO even though the hospital was not in his network. But doctor visits by both Fred and Ethyl prior to his admission were not covered and they had to pay out of pocket.

Fred’s rehab and home health care would not be covered by his plan either since Atlanta providers were not included in his plan.

Their out of pocket expenses had already run more than $1,000 and they were going to become even higher unless they could secure new coverage.

Lucy called me three days before the end of the month, asking for my help in securing new Medicare coverage. Specifically, she wanted a Medicare supplement plan for her parents.

 

What she wanted was impossible

When Lucy called, her dad was still in the hospital and they had not yet notified Social Security of the change in address. The best we could hope for would be to have everything in place by the first of the month following.

In the meantime their non-covered medical expenses were mounting.

Even moving to another Medicare Advantage plan with Georgia networks is possible, but not within the time frame they needed.

Original Medicare has no networks. If Fred and Ethyl had original Medicare and a supplement plan their out of pocket exposure would have been minimal.

Their Medigap plan would also follow them from Louisiana to Georgia without a hitch. No need to change plans. The same coverage they had in Louisiana would continue in Georgia.

Does Medicare work anywhere? Absolutely. So will your Medicare Advantage plan. Just be prepared to pay more when you travel out of the Advantage plan service area, and changing coverage once you arrive may be a challenge.

When you want full coverage anywhere you go, nothing beats original Medicare and a Medicare supplement plan

original medicare supplement coverage

 

Popular searches that lead to this page.

Does Medicare cover me when I travel? Am I still covered by Medicare when I travel out of state? Can I go to any provider when I have a Medicare Advantage plan? How does Medicare Advantage HMO work?

 

#Medicare #MedicareAdvantageHMO

Welcome to Medicare – What’s Covered?

Welcome to Medicare. What’s covered, what isn’t?  In the exam room I notice a sign. “Lab work is not covered by Medicare“. You owe $289. Do not pass go. Do not collect $200.

Welcome to Medicare physical exam? Covered. Lab work? Not covered.  Really? You turned 65 and signed up for Medicare. What happens next?

Here is a short introduction to Medicare. What’s covered, what isn’t,  and what to expect

  • Medicare’s definition of preventive care has surprises
  • Lab work may not be covered
  • Medical necessity is the rule
  • Free exams aren’t always free

Whether you have original Medicare and a supplement or you enrolled in an Advantage plan, the underlying rules of what is covered and what isn’t are the same. The difference is in how you pay for it.

You might want to view our Medicare Exam video on YouTube

Turning 65 – Welcome to Medicare 2019 – What’s Covered?

dr kildareBy the time you reach 65 and enroll in Medicare, most people have a doctor (or doctors) they like and trust. They want to continue that relationship and are not interested in picking a doctor from a list provided by an insurance company.

Georgia Medicare Plans specialize in helping you keep your doctor(s) and finding a Medicare supplement plan that fits your needs and budget. We have rates and information on more than 230 different Medigap plans and will provide a FREE REPORT on all plans based on your age, gender and zip.

You can start your research by comparing rates and benefits for roughly 30 plans by getting an INSTANT GA Medigap quote.

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I understand your confusion. Most people want information so they can understand what lies ahead. They want the time to read, make notes and ask questions.

Most of the insurance agents you will talk to are not old enough to enroll in Medicare and have not experienced it first hand. Bob Vineyard turned 65 in September, 2015 and enrolled in Medicare. In spite of 40 years in the health insurance business and over 400 Medicare clients, I am still learning things every day about how Medicare works.

Ask me anything. Others talk, we listen.

Welcome to Medicare Surprises

When I turned 65 and signed up for Medicare, one of the first things I did was schedule my Welcome to Medicare physical.

Because I chose original Medicare and a supplement plan, I was able to keep my doctor. My group insurance plan required me to have an annual exam and wellness interview so there should not have been any surprises with my Welcome to Medicare exam.

That was the wrong assumption.

While waiting in the exam room I saw a notice on the bulletin board.

Lab work is not covered by Medicare

Seriously? What’s that all about?

Preventive screenings are covered by Medicare in the following situations

  • Abdominal aortic aneurysm scan – Men only, if you smoked 100 cigarettes in your lifetime
  • Bone density – Mostly women, if you are estrogen deficient or have osteoporosis
  • Lab tests – Only if considered medically necessary by Medicare

What is considered medically necessary?

Medicare defines medically necessary as tests or treatment needed to diagnose or treat an illness, injury, condition, disease or symptoms that meet accepted standards of care.

Preventive lab work may not be covered by Medicare.

Congratulations! You are healthy. Your test is not covered!

I take no medications. For the last few years my doctor has run routine lab work to make sure my body is doing what it is supposed to. As much as it galls me to say, my Obamacare plan covered routine tests like CBC, Lipid Panel, CMP, etc. at no charge to me.not covered

These tests were not free. The labs and technicians do not volunteer their time. The costs associated with the lab tests were absorbed by the health insurance carrier and baked into the premiums.

Not so with Medicare.

Those under age 65 pay nothing.

If you are 65 and older, there is no more free lunch.

When I asked about the sign on the wall. The one that said “Lab work is not covered by Medicare” her response took me aback.

Medicare generally doesn’t cover those tests if you are healthy. But if you were sick, they would pay for them.

Sign this ABN form. If Medicare denies the claim you will have to pay the cost of your lab work. You will owe $289.

So much for my “free” Welcome to Medicare exam.

Medicare physical exam.

Is it covered? Is it free? How much will I have to pay?

Original Medicare is quite good in most respects. No more doctor networks. Forget about balance billing (when you use Medicare providers that accept assignment).  Huge bills for health care are a thing of the past.

So exactly what is covered, and what isn’t? Check out this free Guide to Medicare Preventive Services. And yes, it really is free. Click to download.

More ways to save money.

Most of the retirees we talk to are paying too much for their Medicare supplement plan. Many are facing rate increases. One large Mutual company has increased rates 10 times since 2012!

Medigap plan F will be retired in 2020. Switch now if you can. Plan G is popular with over 90% of our clients. Some have not had a rate increase in two years.

Get a free GA Medigap quote.  FREE report listing rates for all plans based on your age, gender and zip code  sent by email once we confirm your information.

GA Medigap quote

You need to be informed. The more you know and understand the better it will be for your bank account.

#MedicareLab #WelcometoMedicare #GAMedicareExpert #GAMedigapRates

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