Author: Todd Reagin

Would you like my help? If you would like to talk to me or schedule a meeting, you can reach me at 207-370-0143 or send an email using the CONTACT button on the menu. I have a passion for helping people and I have found great joy in being able to offer my services to people who need my help.

It’s Open Enrollment!

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Not happy with your current Medicare Insurance Plan? Or just curious if there is a better plan?

Like the song says… “You better shop around!”

This is very good advice!

Whether it is groceries, heating oil, or anything else, everybody wants to get the best value for their money. And today’s options for health insurance can be pretty darn costly. That’s why it’s a good idea to shop around for the right Medicare Advantage or Prescription Drug Plan.

Cost is not the only thing to consider when comparing plans.

There are dozens of Medicare Supplemental plans available in Maine this year, all with different costs. 

Keep the following things in mind when you compare plans to make sure you get the best plan!

  • What are the monthly premiums and deductible costs?
  • What will you pay for the benefits and services you’re likely to use?
  • Is there a limit on what you will have to pay out-of-pocket for the year? 
  • Will you have to change pharmacies if you change plans?
  • What benefits are most important to you? Such as Dental, Vision, Chiropractic

Comparing costs of prescription drug coverage is another part of the cost puzzle. 

  • Do you know how much your prescriptions will cost?
  • Does the plan cover the drugs you take? 
  • What pharmacies will give you the best price?
  • Will the Part D coverage gap (“donut hole”) effect you? If so, when?

Only you can determine what mix of benefits and costs will work best with your needs and budget, but I can help. 

I can help make it easy to compare plans so you can pick one that best meets your needs. 

I can explain everything you need to know and after you’ve narrowed your choices to a few really good plans, together we will review those plans to get more details about their benefits and services. 

I work with all the insurance companies and plans available and I have helped hundreds of people with this decision. I understand these plans and how they work and I can help you understand them too.

And the best part is – you pay nothing for my help!

That’s right. I help you review your plan options and answer all your questions and it won’t cost you a cent!

Why?

This is what agents do. Just like with your car insurance or home owners insurance, as your agent I work for you and I get paid by the insurance companies to help you. And not just now but throughout the year.

I am trained by each insurance company on how their plans work and what they offer plus I have clients who use these plans which gives me real experience helping them year after year.  So, I know which plans are the most popular and why.

Another great thing about having someone on your side is that I am available throughout the year if you have any questions or need help!  So, if you have a problem with the insurance company or if you don’t understand something you get in the mail, I will be here to help with that too!

No one plan is perfect for everyone.  Each plan is different, just like each person is different.  I will help you understand the differences so you can the right choice with confidence!

Would you like my help?

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me by calling 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message. 

Again, the best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available.  I am paid by the insurance companies in the form of a commission if you enroll in a plan.  You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.

“My goal is to help you and I have found great joy in being able to offer my services to people who need my help.”

Book an appointment with Maine Medicare Options using SetMore

Medigap vs. Medicare Advantage

Blog Article, Medicare, Part D Prescription Drug Coverage, Top Posts

“What’s the differences between Medicare Supplements and Medicare Advantage?”

Questions like this are the reason I do what I do.  You need to know what your options are in Maine when you turn age 65 and enroll in Medicare – and there are a lot of options!

There are many differences between Medicare Supplement plans or Medigap as they are called in the Medicare literature.

One difference between Medigap and Medicare Advantage plans is that Medicare Advantage contracts operate on a calendar year basis and can have changes from year to year just like the health insurance plan you had prior to Medicare.  Medicare Supplement policies are standardized and are the same year after year.

Feeling overwhelmed?  Get local help.  Click here.

Another difference is the cost. Medicare Advantage Plans generally have much lower monthly premiums (sometimes $0) And some Medicare Advantage plans pay you!  (Yes you read that right!)  Medigap plans can cost much more, often in the $200/month range.

With Medicare Advantage plans you are required to share in your medical costs by paying co-pays as you use the plans.  These plans operate very similar to the Medical insurance you may have had before you retired if you had an HMO or a PPO plan on the Healthcare marketplace (Obamacare) or with an employer.  Most Medigap plans have very small out of pocket costs while they cost much more up front.

This is why most people turning 65 or planning retirement choose to meet with someone like myself who has the knowledge and experience with the different plans and can help you decide which plan is best for you. Choosing between these two types of Medicare insurance plans is just the first step.

Once you’d decided on Medigap or Medicare Advantage then you must choose which Medigap plan or which Medicare Advantage plan best fits your needs.  You may also need to pick a separate Part D prescription drug plan if the plan you choose does not include drug coverage.

Also, the best plan for you may not always be the best plan for your spouse so you will have to do the same research for both of you.  I can explain everything you need to know so that you can make the best choice.  You can schedule a meeting quickly and easily using this button.

Book an appointment with Maine Medicare Options using SetMore

If you have a question that needs to be answered right away, just give me a call.  My number is (207) 370-0143 or call toll free 866-976-9038.

Want to know more?

If you would like help comparing your needs against the many Medicare plans out there or if you just want to ask a few questions, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message.

The best part about working with me is that it will not cost you anything to talk with me to discuss your options and review the plans that are available.  I am paid by the insurance companies in the form of a commission when you enroll in a plan.  You will not pay anything to meet with me and you will pay the same price for your insurance that everyone pays whether they had my help or not.

“My goal is to help people and I have found great joy in being able to offer my services to people who need my help.”

Book an appointment with Maine Medicare Options using SetMore

Are you turning 65 and still working?  Read this.

Health Savings Account (HSA)

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A Health Savings Account (HSA) is a type of savings account like an IRA that lets you set aside money on a pre-tax basis to pay for qualified medical expenses.

By using untaxed dollars in a HSA to pay for deductibles, copayments, coinsurance, and some other expenses, you may be able to lower your overall health care costs. HSA funds generally may not be used to pay premiums.

While you can use the funds in an HSA at any time to pay for qualified medical expenses, you may contribute to an HSA only if you have a High Deductible Health Plan (HDHP) – generally a health insurance plan that only covers preventive services before the deductible.

For 2020, the minimum deductible for an HDHP is $1,400 for an individual and $2,800 for a family. When you view plans in the Marketplace, you can see if they’re “HSA-eligible.”

For 2020, if you have an HDHP, you can contribute up to $3,550 for self-only coverage and up to $7,100 for family coverage into an HSA. HSA funds roll over year to year if you don’t spend them. An HSA may earn interest or other earnings, which are not taxable.

Some health insurance companies offer HSAs for their HDHPs. Check with your company. You can also open an HSA through some banks and other financial institutions.

HSA funds are not taxed when they are withdrawn from the HSA as long as they are used to pay for qualified medical expenses.
 
Your current employer may oversee your HSA or you may have an individual HSA that is overseen by your bank, credit union or insurance company.

HSA & Medicare

If you have an HSA and you will soon be eligible for Medicare, it is important to plan ahead and understand how enrolling in Medicare will affect your HSA.
 
IMPORTANT:  When you enroll in Medicare Part A you can no longer contribute to your HSA.
 
The month you enroll in Medicare Part A (typically the month of your 65th birthday), the account overseer switches the contributing balance to your HSA to zero dollars per month.
 
By law, people with Medicare are not allowed to put money into an HSA. This is because you must have a high deductible health plan if you are putting money into an HSA and since Medicare will cover costs before your deductible, you no longer meet this criteria.

The Good News!

The good news is you may withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses (deductibles, Part B premiums, copays or coinsurances). If you use the account for qualified medical expenses, it will continue to be tax-free.

Triple Tax Advantage of HSAs

  • Your account contributions are pre-tax or tax-deductible.
  • All earnings, interest, and, yes, investment returns are tax-free.
  • Any withdrawals for qualified medical expenses are tax-free. Plus, once you reach age 65, all non-medical withdrawals are taxed at your current tax rate, just like a traditional IRA. (If you withdraw money for non-medical expenses before you’re 65, then there’s a 20% penalty.)

Should you delay enrolling Medicare?

 
Whether you should delay enrollment in Medicare so you can continue contributing to your HSA depends on your circumstances. If you work for a small employer (fewer than 20 employees) or if you are self-employed you willneed to enroll in Medicare when you first qualify even though you will lose the tax advantages of your HSA.
 
Health care coverage from small employers or individual plans pay secondary to Medicare. This means that if you fail to enroll in Medicare when you are first eligible, you may have little or no health coverage.
 
Health care coverage from large (20 or more employees) employers pays primary before Medicare so you may not need to have Medicare in order to pay your health expenses. This means that if you are currently working for a large employer and you wish to decline Medicare Part A and/or B, you can do so and enroll in Part B later when you lose your current employer coverage.  [Read more about working past age 65.]

Do you live in New Hampshire?

 
New Hampshire has a Medicare Plan similar to your HSA called a Medicare Savings Account (MSA) Plan.   This plan works differently in that instead of you setting money aside for the HSA account, Medicare deposits the money in the account – and you keep it!

Medicare Savings Account (MSA) Plans

 
Medicare Medical Savings Account (MSA) plans are high-deductible healthcare plan that the federal government pays to administer Medicare benefits.
 
Like all Medicare Advantage plans under Part C, MSA plans must provide you with the same benefits, rights, and protections as Original Medicare, but they may do so with different rules, restrictions, and costs.
 
Some MSAs offer additional benefits, such as dental, vision and hearing care but unlike other Medicare Advantage Plans, MSA plans include both a high deductible health plan (HDHP) and a bank account to help pay your medical costs.

MSA plans also come with a bank account where Medicare deposits funds once each year for your medical expenses, which you can use to pay for your deductible.

  • Your plan chooses the bank account and the amount it contributes. 
  • Funds contributed to an MSA are not taxed, as long as they are used to pay for qualified medical expenses.
  • Unlike an HSA, you cannot deposit more money into the account. Once you have used the money in the account, you have to pay out of pocket until you reach your deductible.
  • After reaching your deductible, your MSA plan covers 100% of the cost for Medicare-covered services.

MSA plans do not have provider networks so you may see any doctor, specialist or hospital that accepts Medicare.

Medicare MSA plans are currently only available in New Hampshire but due to their popularity I am confident they will come to Maine very soon.

In my personal opinion, MSA plans are one of the most consumer-friendly products available in the whole Medicare Advantage space – if not the whole of Medicare.
 
[READ MORE ABOUT MSA PLANS]

Still have more Questions?

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If you would like help finding answers to your questions, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message. I am always happy to help!

The best part about working with me is that it costs you nothing! I am paid by the insurance companies in the form of a commission when I enroll someone in a plan.

This is the same way it works when you buy car insurance or your home owners insurance. You do not pay anything to the agent and you will pay the same price for your insurance that everyone pays whether they had my help or not.

“My goal is to help people and I have found great joy in being able to offer my services to people who need my help.”

Book an appointment with Maine Medicare Options using SetMore

BEWARE OF CALLERS!

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IMPORTANT NOTE: Social Security and Medicare do not make phone calls. If either entity needs information from you they will send a letter. They only communicate via the US Postal Service.

“If anyone calls you and asks you for information such as your social security number or Medicare ID number – HANG UP!”

I have been getting a lot of calls recently from clients saying they have been called by someone pretending to work for Social Security or Medicare. They start the conversation innocently enough but then they ask for your Medicare ID number or Social Security number or bank information. If this happens to you – HANG UP!

Social Security and Medicare already have this information. They would never need to ask you for it.

  • Hang up. If someone calls claiming to be from Medicare, asking for your Social Security number or bank information to get your new card or new benefits, that’s a scam.
  • Don’t give personal information to a caller claiming to be from Medicare. You can’t trust caller id. These calls can be spoofed so they look like they’re coming from Medicare even when they’re not. Before you give any personal information, initiate your own call to Medicare at 1-800-MEDICARE.
  • Report the call. Report Medicare imposters at 1-800-MEDICARE or ftc.gov/complaint. The more they hear from you, the more they can help fight scams.

The video below will help you recognize the scammers who ask for your Medicare number so you can get a back or neck brace or who say they need your information or money so you can get a new Medicare card. And you’ll hear from an FTC expert about how to avoid these scams:

The FTC worked with AARP to create a series of videos about imposter scams – including Medicare scams, IRS imposters and robocalls. While the videos are aimed at older Asian Americans and Pacific Islanders, the tips apply to everyone. Watch the video below about how you can protect yourself from Medicare scams: 

For more information about stopping imposter scams, visit ftc.gov/imposters. And to learn about how to stop unwanted calls, including using call blocking technology, go to ftc.gov/calls.

Have more Questions? I can help!

If you would like help finding answers to your questions, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message. I am always happy to help!

The best part about working with me is that it costs you nothing! I am paid by the insurance companies in the form of a commission when I enroll someone in a plan. This is the same way it works when you buy car insurance or your home owners insurance. You do not pay anything to the agent and you will pay the same price for your insurance that everyone pays whether they had my help or not.

“My goal is to help people and I have found great joy in being able to offer my services to people who need my help.”

Book an appointment with Maine Medicare Options using SetMore

VA Benefits and Medicare

Blog Article, Medicare, Part D Prescription Drug Coverage, Top Posts

Learn how your VA Benefits and Original Medicare work

VA Benefits and Medicare: What You Need to Know

As a Medicare-eligible Veteran, you have more options when it comes to healthcare. The transition to Medicare can be confusing, so this article will list a few points that all vets should know when they become Medicare eligible.  To confirm your options call the Veterans Administration directly at 1-877-222-VETS (8387).

VA Benefits and Medicare

It is important to know that Veteran’s (VA) plans and Medicare do not supplement each other. In other words: VA plans only cover care at VA facilities, and Medicare only covers care at Medicare assigned doctors and hospitals.

Should You Enroll in Medicare Part A If You Have VA Benefits?

Yes. You can have both Medicare and Veterans (VA) benefits at the same time.  It is strongly recommended that all veterans enroll in Medicare Part A (Hospital Coverage) when they turn 65 and generally there is no additional cost for Part A. This will allow you receive hospital coverage should you go to a non-VA facility.  According to the VA’s website “All Veterans are encourage you to enroll in Medicare health insurance.” Source: VA.gov

Should You Get Medicare Part B If You Have VA Benefits?

Yes, It is strongly recommended that all veterans enroll in Medicare Part B (Medical Coverage) as well as part A when they are eligible. (Click here to learn more about when to enroll.)

There is a monthly fee for Part B but it is worth it. If your VA Benefits are dropped at some point OR, and this is important, if your local VA facility does not cover all health services, you could pay 100% out of pocket for a serious illness.

The VA highly recommends that you enroll in Part B as well. Please contact Veterans Affairs directly (1-877-222-VETS (8387)) with questions about specific care at Togus or another local facility.

Should You Get a Medigap or Medicare Advantage If You Have VA Benefits?

If you would prefer to see a local doctor or go to a local hospital or healthcare facility for your care then you should consider a Medicare Advantage or Medigap plan to supplement your Medicare coverage. Read more about these types of plans here.

Most people agree that veterans do not need a Medigap plan if they qualify for ChampVA. However, if you aren’t enrolled in ChampVA, a Medigap plan will fill in the gaps such as deductibles, copays, and coinsurance, as well as other benefits when seeking care outside of the VA, or outside of the U.S. and its territories.

Make sure to speak with one of our agents before enrolling in any supplemental plan to ensure that it is actually beneficial for you.

Here are two reasons why you may want to enroll in a private Medicare Supplement plan:

  1. You do not live near a VA facility

  2. You are enrolled in one of the VA lower priority groups, and could potentially lose your benefits

“There is no guarantee that in subsequent years Congress will appropriate sufficient funds for VA to provide care for all enrollment Priority Groups. This could happen if you are enrolled in one of the lower Priority Groups. This would leave you with no health care coverage.” Source: VA.gov

READ MORE ABOUT HOW VETS ARE WINNING WITH MEDICARE ADVANTAGE

VA Benefits and Medicare Part D

The choice of whether to enroll in Part D is up to you. In most cases, you don’t need a Medicare Prescription Drug Plan, aka Medicare Part D, as VA plans may offer more coverage than Medicare’s Rx coverage.

Remember that any prescription prescribed by a non-VA doctor needs to be approved by your VA doctor for the VA to cover it.  This may take extra time and your VA doctor can say that prescription is unnecessary.  Many veterans use a Medicare Advantage plan as a back up because they don’t cost you any extra. [READ MORE]

What about the Part D Penalty?

Good news! Your VA drug coverage is considered creditable coverage so the Part D late enrollment penalty does not apply to you. If you choose not to enroll in Part D when you are first eligible you can still enroll later on in Part D without paying a penalty.

For further questions about Medigap, Medicare Advantage or Medicare Part D, please call (207) 370-0143 or schedule a phone call to discuss your options.

CLICK HERE TO SCHEDULE A PHONE CALL

Plan F vs. Plan G

Blog Article

 

There is a lot of talk lately about the retirement of the Plan F Medicare Supplement.  It is true that it will no longer be available after 2019, but only for those folks who are turning 65 in 2020.

What does it mean for you?

Most people who choose the Medigap or Medicare supplement type plan choose Plan F because it covers 100% of the costs left over after Medicare pays its part of your doctors or hospital bills.

Plan G is another of today’s options that works the same way with one small exception.  It pays 100% of the costs AFTER you pay the Medicare Part B deductible, which for 2019 is only $185.00.

That’s right, $185 is the entire deductible for the year on Medicare Plan G!

And the biggest benefit to Plan G is lower monthly premiums. It’s about $40 less per month than Plan F so it can save you money. Most of my clients who currently have Plan F have already changed to Plan G.

Has your monthly premium increased a lot this year?

Because more people are choosing to leave Plan F and move over to Plan G the cost of Plan F will increase a lot in 2020. If you have already received notice of your increase and want to compare costs CLICK HERE.

Medigap Plans are standardized so Plan F is Plan F and Plan G is Plan G. Insurance companies charge different rates to administer these plans but they work exactly the same. So I always advise my clients to enroll in the least expensive one.

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Below are some common questions and answers about changing plans.

When can you switch your Medigap policy?

If you have had a Medicare supplement plan since you turned 65, in most cases you can change to the same or a lower plan (from plan “F” to plan “G”) at the same or another company without having to wait for open enrollment.

IMPORTANT: If you don’t have a guaranteed issue right, or it’s outside your Medigap open enrollment period, you may have to answer some medical questions. To find out what your options are you can contact me. I’m happy to answer any questions you have or help you switch.

What if you switch and you don’t like your new plan?

You have the right to change your mind and cancel your new Medigap policy within the first 30 days if you are not satisfied with it. This is called your “free-look period”. The 30 day free-look period starts when you get your new policy. And depending on where you live or what insurance company you’re with, you may have additional opportunities after the 30 days to change back.

Do you have to switch Medigap policies if you move to another state?

No. You can keep your current Medigap policy in any state as long as you are still enrolled in Original Medicare (Part A and Part B). But it’s a good idea to shop around because you may find the same plan for a lower cost in your new state. Rates vary widely from state to state.

Now that you know more about changing Medicare Supplement plans, you may be wondering about your current coverage. Or maybe you don’t have a Medigap policy and would like to make a more detailed comparison of your options.

Whatever your situation or your concerns, I would love to help you figure out the best course of action. To get to know me a bit better, take a look at the ABOUT page and read some testimonials from my clients.

If you’d rather start by getting more information in front of you, use the button below, which lets you schedule a phone appointment with me, or I can email you personalized information about Medicare Supplement plans available in Maine or New Hampshire.

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Book an appointment with Maine Medicare Options using SetMore

If you want assistance right away, I am happy to help you by phone. Give me a call toll free at (866) 976-9038 or call (207) 370-0143.

I’m here to support you and help it all make sense.

Would you like my help?

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message.

The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available.  I am paid by the insurance companies in the form of a commission if you enroll in a plan.

You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.  My goal is to help you and I have found great joy in being able to offer my services to people who need my help.

If you are turning 65 this year or retiring,
you may have questions.

Call me today and I will be happy to explain all your options and help you compare plans so you can choose the coverage you need for a price you can afford.

Schedule a phone call or an in-person meeting.

I can answer all your questions over the phone or we can meet face-to-face and I can help you with everything you need to know. I have all the forms and applications you need and I can also help you complete them.

Compare Medicare Supplements

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IMPORTANT NOTE: Starting January 1, 2020, Medigap plans sold to new people with Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F will no longer be available to people new to Medicare starting on January 1, 2020. If you already have either of these 2 plans (or the high deductible version of Plan F) or are covered by one of these plans before January 1, 2020, you’ll be able to keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans.

Compare Medicare Supplement (Medigap) policies side-by-side

If you live in Massachusetts, Minnesota, or Wisconsin, Medigap policies are standardized in a different way.

Would you like my help?

If you would like help finding the right plan or just want to ask a few questions, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message. The best part about working with me is that it will not cost you anything to talk with me to discuss your options and review the plans that are available.

I am paid by the insurance companies in the form of a commission when you enroll in a plan. You will not pay anything to meet with me and you will pay the same price for your insurance that everyone pays whether they had my help or not.

“My goal is to help people and I have found great joy in being able to offer my services to people who need my help.”

Book an appointment with Maine Medicare Options using SetMore

2019 Medicare Costs

Blog Article, Medicare, Part A, Part B, Part C Medicare Advantage, Part D Prescription Drug Coverage, Top Posts

Medicare Part A

Most people don’t pay a monthly premium for Part A (sometimes called “premium-free Part A”).  If you paid Medicare taxes for 40 or more quarters and you have earned your Social Security Benefit then you will not pay the Part A premium.  You have earned it through your taxes.

However, if you paid Medicare taxes for less than 30 quarters, the standard Part A premium you will pay is $437.  

If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $240. 

Medicare Part B

The standard Part B premium amount for 2019 will increase by $1.50. The premium will increase from $134 to $135.50.

Medicare Deductibles

The annual deductible for all Part B beneficiaries will be $185.00 in 2019.  However, depending on the insurance plan you choose, this deductible may be covered by your supplmental insurance plan.

The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,364.00 in 2019.. The Part A deductible covers your share of costs for the first 60 days of Medicare-covered inpatient hospital care per stay in the hospital. After this 60 day period the daily coinsurance amount will be $341 for days 61 through 90 and $682 for each lifetime reserve day used.  Again, depending on the insurance plan you choose, these deductibles and some coinsurance amounts may be covered by your insurance plan.

Higher income households will pay more.

If your household income is more than $85,000 and you are single or more than $170,000 and married you will pay a higher monthly premium for Part B that will be between $189.60 to $460.50 depending on your income.  Click here to download a pamphlet from Social Security titled, “Medicare Premiums: Rules for Higher-Income Beneficiaries for more information.”

Your income is based on your tax return from 2 years prior.  Meaning for 2019 Social Security will use your tax return from 2017 to determine your household income.  But you may be able to get the high-income surcharge reduced or eliminated if your income has decreased since then because of certain life-changing events, such as the death of a spouse, divorce, retirement or reduced work hours.  In that case, you can ask Social Security to use your more recent income instead.  Contact the Social Security Administration, estimate your 2019 income, and provide evidence of the change, such as a marriage or death certificate, a signed statement of retirement from your employer, or pay stubs showing your reduced income.nk is external)

Are you retiring in 2019?

There is no cost or obligation for you to talk to me and get the answers to your questions.  I welcome all questions and it is my goal to be the single best resource in the state for such questions. And when the time comes for you to enroll in a Medicare Supplement and Prescription Drug Plan, I will help you with that too.

I am a licensed insurance agent working in Maine and New Hampshire.  I have contracts with the top health insurance companies available in the area.  I am able to help you via email, on the phone, or in person.

If you would like to review your options over the phone or schedule a meeting at your home or office you can reach me at 207-370-0143 or schedule an appointment on my booking website here.(link is external)

“The best part about working with me is that it costs you nothing and you benefit from my full knowledge and experience.”

That’s right.  You pay nothing to meet with me.  I am paid by the insurance companies in the form of a commission when you enroll in a plan. You pay the same price for the insurance whether you go direct to the insurance company or take advantage of working with someone who has experience and knowledge to help guide you. My goal is to help people and I have found great joy in being able to offer my services to people who need my help.

Would you like my help?

If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message.  The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available.  I am paid by the insurance companies in the form of a commission if you enroll in a plan.  You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.

“My goal is to help you and I have found great joy in being able to offer my services to people who need my help.”

Book an appointment with Maine Medicare Options using SetMore

2019 Part D Costs

Blog Article, Medicare, Part D Prescription Drug Coverage, Top Posts

The Centers for Medicare and Medicaid Services (CMS) has released the 2019 costs for a standard Part D prescription drug plans.

Here are the highlights for the CMS defined Standard Benefit Plan changes from 2018 to 2019. This “Standard Benefit Plan” is the minimum allowable plan to be offered by insurance company who has a contract with Medicare to offer Part D prescription drug insurance.

  • Initial Deductible:
    will be increased by $10 to $415 in 2019.
  • Initial Coverage Limit (ICL):
    will increase from $3,750 in 2018 to $3,820 in 2019.
  • Out-of-Pocket Threshold:
    will increase from $5,000 in 2018 to $5,100 in 2019.
  • Coverage Gap (donut hole):
    begins once you reach your Medicare Part D plan’s initial coverage limit ($3,820 in 2019) and ends when you spend a total of $5,100 in 2019.
    In 2019, Part D enrollees will receive a 75% discount on the total cost of their brand-name drugs purchased while in the donut hole. The 70% discount paid by the brand-name drug manufacturer will apply to getting out of the donut hole, however the additional 5% paid by your Medicare Part D plan will not count toward your TrOOP (True Out Of Pocket).
    For example: if you reach the donut hole and purchase a brand-name medication with a retail cost of $100, you will pay $25 for the medication, and receive $95 credit toward meeting your 2019 total out-of-pocket spending limit.
    Enrollees will pay a maximum of 37% co-pay on generic drugs purchased while in the coverage gap (a 63% discount). For example: If you reach the 2019 Donut Hole, and your generic medication has a retail cost of $100, you will pay $37. The $37 that you spend will count toward your TrOOP (True Out Of Pocket).
  • Minimum Cost-sharing in the Catastrophic Coverage Portion of the Benefit**:
    will increase to greater of 5% or $3.40 for generic or preferred drug that is a multi-source drug and the greater of 5% or $8.50 for all other drugs in 2019.
  • Maximum Co-payments below the Out-of-Pocket Threshold for certain Low Income Full Subsidy Eligible Enrollees:
    will increase to $3.40 for generic or preferred drug that is a multi-source drug and $8.50 for all other drugs in 2019. 

If you live in Maine or New Hampshire and would like to learn more about the new Medicare plans for 2019 or to go over the changes in your plan, you can call me at (207) 370-0143 or CLICK HERE to send me an email message.

You can also use the BOOK APPOINTMENT(link is external) button below to set up a time to speak with me on the phone or in person. I can also send you information in the mail if you choose. 
Have a question that needs to be answered right away?  You can talk to a licensed insurance agent by calling (207) 370-0143 or toll free 866-976-9038.
Book an appointment with Maine Medicare Options using SetMore

C.O.B.R.A.

Blog Article, COBRA, Insurance, Top Posts

Everything you need to know about COBRA

COBRA provides the ability for you and the dependents covered on your health plan to keep coverage after you lose your job or lose coverage for other reasons.

You are eligible for COBRA if your employer’s health plan covers at least 20 employees and you have had an acceptable “qualifying event.”   

A qualifying event is something that causes you or your dependents to lost health coverage, such as termination of employment, loss of full-time status, divorce or legal separation, or turning 26 (in the case of your children.)

If you have one of these events, your employer will notify you of your option to enroll in COBRA coverage within 14 days of the plan ending.  You will then have 60 days to decide if you want to enroll.

You can keep COBRA coverage for 18 or 36 months, depending on the qualifying event.

In general, COBRA only applies to employers with 20 or more employees. 

But, some states require employers covering employers with fewer than 20 employees to let you keep your coverage for a limited time.  This is often referred to as “Mini-COBRA” and you can read more about how Maine handles this here:  https://www.maine.gov/pfr/insurance/faq/cobra_faqs.html
 

Your Employer’s Responsibility:

The employer must tell the plan administrator if you qualify for COBRA because of one of these reason:

  • The covered employee dies
  • The covered employee lost her/her job
  • The covered employee becomes entitled to Medicare
Once the plan administrator is notified they must let you know you have the right to choose COBRA coverage.
 

Your Responsibility:

You or the covered employee are responsible to notify the plan administrator if you qualify because of on of the following reasons:
  • You’ve divorced or legally separated from the covered employee
  • You were a dependent child or dependent adult who is no longer a dependent.
You will need to tell the plan administrator about your change in situation within 60 days of the change in order to qualify for COBRA.
 
 

COBRA and MEDICARE:

Something really great about COBRA that is not widely known is that if the covered employee becomes entitled to Medicare and the spouse is a few years younger, you do not have to keep working to keep your spouse insured.   Your spouse and dependents may keep COBRA for up to 36 months if you lost coverage due to enrolling in Medicare!
 
You may also keep COBRA coverage for services that Medicare does not cover, such as vision and dental. 
 
You may – for example – if you have COBRA dental insurance, the insurance company that provides your COBRA coverage may allow you to drop your medical coverage but keep paying the premium for the dental coverage as long as you are entitled to COBRA coverage.
 
If you have Medicare Part A or Part B when you become eligible for COBRA, you must be allowed to enroll in COBRA if you choose.   Medicare will be the primary insurance and COBRA will be secondary.  You should keep Medicare because it is responsible for paying the majority of your health care costs.
 
NOTE:  COBRA is typically much more expensive than the most expensive Medicare plans so it makes sense to talk to an agent or broker like myself to know your options before you decide to go with COBRA and compare costs.

 

Read more about working with an agent.

 

 
If you have questions about Medicare or COBRA, you can reach out to me using the CONTACT button on the menu at the top of this website or by calling (207) 370-0143.  You can also reach out to the government agencies below.
 
If you are leaving a government employer contact:
The Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627.
 
If you are leaving a private employer contact:
The US Department of Labor at 1-866-487-2365
Maine DOL: (207) 623-7900
New Hampshire DOL: (603) 271-3176
 
 
If your employer group health plan coverage was from a state or local government employer then call
The Centers or Medicare and Medicaid Services (CMS) at 1-877-267-2323 extension 61565.
 
 
 

Would you like my help?

If you would like help finding the right plan or just want to ask a few questions, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message.  The best part about working with me is that it will not cost you anything to talk with me to discuss your options and review the plans that are available.  I am paid by the insurance companies in the form of a commission when you enroll in a plan.  You will not pay anything to meet with me and you will pay the same price for your insurance that everyone pays whether they had my help or not.

“My goal is to help people and I have found great joy in being able to offer my services to people who need my help.”

Book an appointment with Maine Medicare Options using SetMore

 

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