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.

Medicare Supplement Discounts

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Shop Around And Save!

Medicare Supplement (Medigap) plans are standardized plans which means that Plan G and Plan F is the same no matter which insurance company offers it.  The insurance company must offer the same exact benefits for each letter plan A through N.  For this reason, once I have helped my clients determine which plan is the best fit, I compare the different rates to find the best price for them – including any discounts available!

Look for a Household Discount.

If you and your spouse both have a Medigap plan with the same insurance company you could get 12% off the total cost.  This discount will apply even if one of you started your plan earlier, and the other is a new to Medicare this year.  You will both get the discounted rate once you are both enrolled.

Which Companies Offer Discounts?

Here is a list of the companies that currently offer household discounts on Medigap type plans.

  • Aetna
  • Anthem / Blue Cross Blue Shield
  • United American

Learn More about Medigap Get a Medigap Quote

Your Next Steps…

Household discounts aren’t listed in online quoting websites, so you’ll want to talk to an independamt agent who works with multiple insurance companies and can compare the rates for you.

Call me today to get more information or rates.  My direct line is 207-370-0143. I can help you figure out the best Medicare insurance plan for your needs.

Click here to learn about Medicare Advantage Plans under Part C of Medicare and how they compare to Medigap plans.

Would you like my help?

If you would like to talk to me, ask a question or schedule a meeting at your home or a nearby meeting place, 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 any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you talk with me.

“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

How and When to Enroll in Medicare

Blog Article, Medicare, Part D Prescription Drug Coverage
You have several options when the time comes for you to enroll in Medicare. For some people, Medicare enrollment is automatic, while for others, it may depend on when and how they become eligible.

How to enroll in Medicare

You can enroll in Medicare Part A and/or Medicare Part B in the following ways:

  • Online at www.ssa.gov/medicare
  • By calling Social Security at 1-800-772-1213 (TTY users 1-800-0778), Monday through Friday, from 7AM to 7PM.
  • In-person at your local Social Security office. Find yours here: www.ssa.gov/locator/
  • If you worked for the railroad, enroll in Medicare by contacting the Railroad Retirement Board (RRB) at 1-877-772-5772 (TTY users 1-312-751-4701). You can call Monday through Friday, 9AM to 3:30PM, to speak to an RRB representative.

When to enroll in Medicare

There are a few situations where Medicare enrollment may occur automatically:
  • If you are receiving retirement benefits:
  • If you’re already collecting Social Security or Railroad Retirement Board retirement benefits when you turn 65, you will automatically be enrolled in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
  • If you are receiving disability benefits:
  • If you are under 65 and receiving certain disability benefits from Social Security or the Railroad Retirement Board, you will be automatically enrolled in Original Medicare, Part A and Part B, after receiving 24 months of disability benefits. The exception to this is if you have end-stage renal disease (ESRD). If you have ESRD and had a kidney transplant or need regular kidney dialysis, you can apply for Medicare. If you have amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease), you will automatically be enrolled in Original Medicare in the same month that your disability benefits start.

If you are still working and don’t need Medicare Part B:

If you’re automatically enrolled in Medicare Part B, but do not wish to keep it you have a few options to drop the coverage. If your Medicare coverage hasn’t started yet and you were sent a red, white, and blue Medicare card, you can follow the instructions that come with your card and send the card back. If you keep the Medicare card, you keep Part B and will need to pay Part B premiums. If you signed up for Medicare through Social Security, then you will need to contact them to drop Part B coverage. If your Medicare coverage has started and you want to drop Part B, contact Social Security for instructions on how to submit a signed request. Your coverage will end the first day of the month after Social Security gets your request.
 
If you have health coverage through current employment (either through your work or your spouse’s employer), you may decide to delay Medicare Part B enrollment. You should speak with your employer’s health benefits administrator so that you understand how your current coverage works with Medicare and what the consequences would be if you drop Medicare Part B.
 

Medicare Part B late-enrollment penalty:

If you do not sign up for Medicare Part B when you are first eligible, you may need to pay a late enrollment penalty for as long as you have Medicare. Your monthly Part B premium could be 10% higher for every full 12-month period that you were eligible for Part B, but didn’t take it. This higher premium could be in effect for as long as you are enrolled in Medicare. For those who are not automatically enrolled, there are various Medicare enrollment periods during which you can apply for Medicare. Be aware that, with certain exceptions, there are late-enrollment penalties for not signing up for Medicare when you are first eligible.
 
One exception is if you have health coverage through an employer health plan or through your spouse’s employer plan, you can delay Medicare Part B enrollment without paying a late-enrollment penalty. This health coverage must be based on current employment, meaning that COBRA or retiree benefits aren’t considered current employer health coverage.
 

Medicare Initial Enrollment Period

For most people, enrolling in Medicare Part A is automatic. However, there are several instances where you may have to manually enroll in Medicare Part A and/or Part B during your Initial Enrollment Period (IEP), the seven-month period that begins three months before you turn 65, includes the month of your 65th birthday, and ends three months later.
 
Some situations where you would enroll in Medicare during your initial enrollment include:
  • If you aren’t yet receiving your retirement benefits:
  • If you are not yet receiving retirement benefits and are close to turning 65, you can sign up for Medicare Part A and/or Part B during your IEP. If you decide to delay your Social Security retirement benefits or Railroad Retirement Benefits (RRB) beyond age 65, there is an option to enroll in just Medicare and apply for retirement benefits at a later time.
  • If you do not qualify for retirement benefits:
  • If you are not eligible for retirement benefits from Social Security or the RRB, you will not be automatically enrolled into Original Medicare. However, you can still sign up for Medicare Part A and/or Part B during your IEP. You may not be able to get premium-free Medicare Part A, and the cost of your monthly Part A premium will depend on how long you worked and paid Medicare taxes. You will still have to pay a Medicare Part B premium.

Medicare General Enrollment Period

If you did not enroll during the IEP when you were first eligible, you can enroll during the General Enrollment Period. The general enrollment period for Original Medicare is from January 1 through March 31 of each year. Keep in mind that you may have to pay a late enrollment penalty for Medicare Part A and/or Part B if you did not sign up when you were first eligible.
 

Medicare Special Enrollment Period

You may choose not to enroll in Medicare Part B when you are first eligible because you are already covered by group medical insurance through an employer or union. If you lose your group insurance, or if you decide you want to switch from your group coverage to Medicare, you can sign up at any time that you are still covered by the group plan or during a Special Enrollment Period (SEP).
 
Your eight-month special enrollment period begins either the month that your employment ends or when your group health coverage ends, whichever occurs first. If you enroll during an SEP, you generally do not have to pay a late enrollment penalty.
 
The Special Enrollment Period does not apply if you’re eligible for Medicare because you have ESRD. Please also keep in mind that COBRA and retiree health coverage are not considered current employer coverage and would not qualify you for a special enrollment period.
 

Medicare Advantage plan enrollment

Medicare Advantage, also known as Medicare Part C, is another way to receive Original Medicare benefits and is offered through private insurance companies. At minimum, all Medicare Advantage plans must offer the same Medicare Part A and Part B benefits as Original Medicare. Some Medicare Advantage plans also include additional benefits, such as prescription drug coverage. You must have Original Medicare, Part A and B, to enroll in a Medicare Advantage plan through a private insurer.
 
You can enroll in a Medicare Advantage plan during two enrollment periods, the Initial Coverage Election Period and Annual Election Period.
 

Medicare Advantage plan Initial Coverage Election Period:

Most beneficiaries are first eligible to enroll in a Medicare Advantage plan during the Initial Coverage Election Period. Unless you delay Medicare Part B enrollment, this enrollment period takes place at the same time as your Initial Enrollment Period (IEP), starting three months before you have both Medicare Part A and Medicare Part B and ending on whichever of the following dates falls later:
 
The last day of the month before you have both Medicare Part A and Part B, or
The last day of your Medicare Part B Initial Enrollment Period.
If you’re under 65 and eligible for Medicare due to disability, your IEP will vary depending on when your disability benefits started.
 

Medicare Advantage plan Annual Election Period:

You can also add, drop, or change your Medicare Advantage plan during the Annual Election Period, which occurs from October 15 to December 7 of every year. During this period, you may:
  • Switch from Original Medicare to a Medicare Advantage plan, and vice versa.
  • Switch from one Medicare Advantage plan to a different one.
  • Switch from a Medicare Advantage plan without prescription drug coverage to a Medicare Advantage plan that covers prescription drugs, and vice versa.

Medicare Advantage Disenrollment Period:

You’ll have the opportunity to disenroll from your Medicare Advantage plan and return to Original Medicare during the Medicare Advantage Disenrollment Period, which runs from January 1 to February 14. You cannot use this period to switch Medicare Advantage plans or make other changes. However, if you decide to drop your Medicare Advantage plan, you can also use this period to join a stand-alone Medicare prescription drug plan, since Original Medicare doesn’t include prescription drug coverage.
 
Outside of the Annual Election Period and the Medicare Advantage Disenrollment Period, you cannot make changes to your Medicare Advantage plan unless you qualify for a Special Election Period.
 

Medicare prescription drug coverage

Medicare prescription drug coverage is optional and does not occur automatically. You can receive coverage for prescription drugs by either signing up for a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes drug coverage, also known as a Medicare Advantage Prescription Drug plan. Medicare prescription drug plans and Medicare Advantage plans are available through private insurers. Please note that you cannot have both a stand-alone Medicare prescription drug plan and a Medicare Advantage plan that includes drug coverage.
 

Initial Enrollment Period for Medicare Part D:

You can enroll in a stand-alone Medicare prescription drug plan during your Initial Enrollment Period for Part D. You are eligible for drug coverage if:
  • You live in a service area covered by the health plan, and
  • You have Medicare Part A AND/OR Medicare Part B.
Generally, your Initial Enrollment Period for Part D will occur at the same time as your Initial Enrollment Period for Medicare Part B (the seven-month period that starts three months before your eligibility for Part B, includes the month you are eligible, and ends three months later).
 
Once you are eligible for Medicare Part D, you must either enroll in a Medicare prescription drug plan, Medicare Advantage Prescription Drug plan, or have creditable prescription drug coverage (that is, drug coverage that is expected to pay at least as much as standard Medicare prescription drug coverage). Some people may choose to delay Medicare Part D enrollment if they already have creditable drug coverage through an employer group plan.
 
However, if you do not sign up for prescription drug coverage when you are first eligible for Part D, you may have to pay a late-enrollment penalty for signing up later if you go without creditable prescription drug coverage for 63 or more consecutive days.
 

Medicare Part D Annual Election Period:

If you did not enroll in drug coverage during IEP, you can sign up for prescription drug coverage during the Annual Election Period that runs every year from October 15 to December 7.
 
During AEP, you can:
  • Sign up for a Medicare prescription drug plan.
  • Drop a Medicare prescription drug plan.
  • Join a Medicare Advantage plan that includes prescription drug coverage.
  • Switch from a Medicare Advantage plan that doesn’t include drug coverage to a Medicare Advantage plan that does (and vice versa).
  • Outside of the Part D Initial Enrollment Period and the Annual Election Period, the only time you can make changes to prescription drug coverage without a qualifying Special Election Period is during the Medicare Advantage Disenrollment Period (MADP)–but only if you are dropping Medicare Advantage coverage and switching back to Original Medicare. The Medicare Advantage Disenrollment Period runs from January 1 to February 14.
Medicare Part A and Part B do not include prescription drug coverage, and if you switch back to Original Medicare during the Medicare Advantage Disenrollment Period, you will have until February 14 to join a stand-alone Medicare prescription drug plan.
 
 

Medicare Supplement Costs for Maine and New HampshireMedicare Supplement plans enrollment

Medicare Supplement Plans (or Medigap) are voluntary, additional coverage that helps fills the gaps in coverage for Original Medicare. The best time to enroll in a Medicare Supplement plan is during your individual Medigap Open Enrollment Period, which is the six-month period that begins on the first day of the month you turn 65 and have Medicare Part B. If you decide to delay your enrollment in Medicare Part B for certain reasons such as having health coverage based on current employment, your Medigap Open Enrollment Period will not begin until you sign up for Part B.
 
During your Medigap Open Enrollment Period, you have a “guaranteed-issue right” to buy any Medicare Supplement plan you choose. This means that insurance companies cannot reject your application for a Medicare Supplement plan based on pre-existing health conditions or disabilities. They also cannot charge you a higher premium based on your health status. Outside of this open enrollment period, you may not be able to join any Medicare Supplement plan you want, and insurers can require you to undergo medical underwriting. You may have to pay more if you have health problems or disabilities.
 
Medicare Supplement plans, like Medicare Advantage plans, are offered through private insurance companies, and are available for purchase through brokers like myself.
 
 

Do you have more questions?

Call me today at (207) 370-0173 or use the form on the CONTACT page by clicking here to send me an email to get answers to your Medicare questions or to discuss the Medicare plan options that may be right for you.  

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.  

Book an appointment with Maine Medicare Options using SetMore

“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.”

Medigap High-Deductible Plan F Costs

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If you are considering the High Deductible Plan F then please do the math first.

A Regular Plan F covers 100% of your out of pocket costs and is roughly $200 per month. A High-Deductible Plan F is about one third of the monthly cost but it has a $2,400 deductible in 2018 which you must pay down before it will pay any of your cost shares.

In a worst case scenario where your medical bills exceed the deductible your total cost on the High Deductible plan would be well over $3,000 when you include the monthly premiums.

With Plan F your total cost is $2,400.

If you need the type of coverage that Plan F offers then why would you choose the high deductible option when it will likely cost you more? And if your goal in choosing the Hi-F plan is to save money, well there are better plans out there that can save you more money in the long run.

When comparing Medicare supplement plans most people focus on the monthly premium but there is a lot more to picking the right plan.

Most times people consider the High Deductible Plan F option because they are looking for the least expensive option.  If you are still fairly healthy and don’t go to the doctors often you might think, “Why pay $200 per month if I only see doctors a few times each year?”

The answer is don’t!

…and don’t spend $50-75 per month either!

If you are in good health and only see a doctor a few times a year with a few blood tests during the year, then you should be considering a Medicare Advantage plan. 

Medicare Advantage plans have even lower monthly premiums than Medicare Supplements. Generally, monthly premiums are under $20 per month, they rarely have a deductible and you’ll only pay $5-$10 at your doctors office instead of the FULL AMOUNT as you’d pay if you had the Hi-F plan!

So, my advice is to consider all your options and talk to a professional, like myself who can help you compare the advantages and disadvantages of each plan and help you choose the best plan for you. Perhaps you’ll find out that the Hi-F plan is actually the right choice for you. Perhaps not. But at least you’ll know for sure!

To learn more about Medicare Advantage plans click here.

To compare rates, click here.

AND BEST OF ALL: Working with me will cost you NOTHING!  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.

Would you like my help?

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.  

“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.

Did you enroll in the wrong plan?

Blog Article, Medicare, Part D Prescription Drug Coverage

Did you enroll in a Medicare Advantage Plan or Part D drug plan by mistake or were you misled?

 

One of today’s options is to use The Medicare Advantage Disenrollment Period.

You can switch from your Medicare Advantage Plan to Original Medicare during this period. You can only make this coverage change if you have a Medicare Advantage Plan. The Disenrollment Period occurs each year from January 1 to February 14.

If you have a Medicare Advantage Plan you will be able to switch to Original Medicare with or without a stand-alone prescription drug plan. Any changes made during this period will become effective the first of the following month.

For example, if you switched from a Medicare Advantage Plan to Original Medicare and a stand-alone prescription drug plan in February, your new coverage would begin March 1st.

Note: If you are enrolled in a PFFS plan with a stand-alone drug plan, you must keep your stand-alone prescription drug plan if you switch to Original Medicare during the Annual Disenrollment Period.

What if you miss the annual disenrollment period?

 

You ALSO have the right to disenroll and change plans if you…

  • …joined unintentionally. For example, you may have enrolled believing you were joining a Traditional Medicare Supplement (Medigap plan) or a stand-alone Part D plan that would supplement Original Medicare. You did not realize you were joining a Medicare Advantage plan with a limited doctor network through which you must get all of your Medicare health benefits.
  • …joined based on incorrect or misleading information. You may have been misled, for example, if a plan representative told you that your doctors are in the plan’s network but they are not, or if you were promised benefits that the plan does not really cover.
  • Through no fault of your own, ended up or were kept in a plan you do not want. For example, if you tried to switch plans but were kept in your old plan, you have the right to disenroll and change plans. You can also make a change if you were enrolled in plan through an administrative or computer mistake.

How you should request disenrollment depends on whether or not you have use services.

  • If you have used health services since you joined your plan (for example, you saw a doctor or filled a prescription), and your plan has denied coverage for services, you may want to request retroactive disenrollment or disenrollment back to the date you enrolled in the health plan. Retroactive disenrollment allows you to be disenrolled from a Medicare Advantage or Part D plan as if you had never joined it. Depending upon your situation, you may then wish to select Original Medicare (with or without a Part D plan) or a Medicare Advantage Plan with or without drug coverage. If you are granted retroactive disenrollment, once the request has officially gone through, you should ask any doctor who gave you care during the time when you were enrolled in the plan to refile the claims with Original Medicare and/or, your new Medicare Plan(s).
  • If you have not used any health services since you’ve had your Medicare Advantage Plan, you may want to request a special enrollment period to disenroll from your plan and make a new choice going forward. If your request is granted, you will be disenrolled from your plan at the end of the month in which you made the request. Such requests are generally processed faster than retroactive disenrollment requests. To prevent gaps in coverage, you should sign up for new coverage right away so that it starts as soon as you are disenrolled from the plan you did not want.

To request a retroactive disenrollment or a special enrollment period, call 1-800 MEDICARE and explain to the customer service representative exactly what happened to cause you to join the plan by mistake.

Would you like my help?

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

You will not pay anything for my help.  I am paid by the insurance companies in the form of a commission when you enroll in a plan.  You do not pay any more than anyone else for your insurance and you are under no obligation whatsoever to enroll or change plans if you meet with me.  

Book an appointment with Maine Medicare Options using SetMore

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

 

 

 

 

Want Some Advice? Shop Around!

Blog Article, Medicare, Part D Prescription Drug Coverage

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 supplement.

Cost is not the only thing to consider.

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

Keeping the following things in mind will help you make a smart choice and get a plan that meets your specific health care needs.

  • How much are each plan’s premiums and deductibles?
  • How much 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? 
  • If you’re currently enrolled in a plan, how does that plan stack up to the other plans that are available this year?

Comparing costs of today’s options for prescription drug coverage is another part of the cost puzzle. 

  • Do you know how much your prescriptions will cost under each plan? 
  • Does the plan cover the drugs you take? 
  • Will the Part D coverage gap (or “donut hole”) effect you?

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

Meeting with me will make it easy to compare plans so you can pick one that best meets your needs. 
I will explain everything you need to know and after we’ve narrowed your options to a few really good plans, together we will review those plans to get more details about their benefits and services. 

And you pay nothing for my help!

That’s right. I will help you review your plan options.  I can answer any questions you have about these plans because I am trained by each insurance companies on how the plans work plus I have clients who use these plans and I have real experience helping them year after year.  And I am available throughout the year if you have any questions or need help! 

This means you get to benefit from other people’s experiences!

I will show you which medicare supplements will cost you less and I will also share with you which medicare plans my customers prefer based on their experiences with customer service and working with the insurance company so you’re not stuck fighting to get them to pay for something.
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 make a 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 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

Does Medicare Cover Acupuncture or Chiropractic?

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For help tracking down supplemental insurance or if you have additional questions about alternative treatment, please call Todd at 207-370-0143

Acupuncture and Chiropractic are alternative ways to help with pain management, as well as other wellness benefits – some people find acupuncture helps them to quit smoking. Out of pocket costs for chiropractic and acupuncture can be hard on your wallet, so many of my clients often ask if Medicare covers acupuncture and chiropractic?

Let’s Talk About Acupuncture First.

Medicare does not cover acupuncture. Medicare offers some coverage for physical, occupational, and speech therapy but no acupuncture as of yet. But don’t get discouraged by this answer! Some insurance plans do cover acupuncture. Read on.

Does Medicare Cover Chiropractic Care?

Medicare does cover medically necessary chiropractic services. According to the Center for Medicare & Medicaid Services (CMS), Medicare Part B now covers 80% of the cost for “manipulation of the spine to correct a subluxation.” There is no cap on the number of medically necessary visits to a chiropractor.

Under Original Medicare, without any additional insurance, you would have to pay your part B deductible and 20% coinsurance for all medically necessary chiropractic appointments.

Do Supplemental Plans Cover Chiropractic and Acupuncture?

Traditional Medicare Supplements (also known as Medigap plans) do not cover acupuncture either. These plans will help pay the left over costs once Medicare has paid their share so if it’s not covered by Medicare then the Medigap plan will not pay either.

Medigap plans do cover chiropractic care. Medigap plan “C” and plan “F” cover 100% of your Part B deductible and will also pay the 20% coinsurance. Combined with Medicare there will be no charge for any medically necessary chiropractic work.

Do Medicare Advantage Plans Cover Chiropractic and Acupuncture?

Yes, some plans in Maine and New Hampshire do offer coverage for these treatments and More!

Some Medicare Advantage (Part C) plans will reimburse you for certain services not covered by Original Medicare. These include Acupuncture, Dental, Fitness Benefits, and Naturopathic Services. Since Part C plans are not standardized, each plan can offer a very different set of fees and benefits. Plans that have these wellness benefits are rare but worth searching for if that is a high priority. Chiropractic is usually available with a Medicare Advantage plan but how much you will pay can vary by plan.

For help tracking down which Medicare Advantage plans offer the benefits you need or if you have additional questions about other alternative treatments, send me a message using the CONTACT ME page on the menu above or call me at 207-370-0143.

Related Content

> > Compare Medicare Advantage and Medigap

> > Help is there – When you need it!

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

 

CMS Lifts Sanctions on Cigna

Blog Article, Medicare, Part D Prescription Drug Coverage

UPDATED on July 12, 2017.

Cigna, whose Medicare Advantage business has been under sanctions for 18 months, is once again free to enroll customers in MA plans beginning July 1, according to a filing from the Securities and Exchange Commission.

The Centers for Medicare and Medicaid Services lifted a suspension placed in January 2016 after “widespread and systemic” failures that prevented members from accessing medical services. According to Reuters New Reporting Service, the governments imposed sanctions when it learned Cigna failed to “handle complaints and grievances properly from patients who had been denied coverage for health benefits or drugs.” The audit also found issue with its list of covered drugs.

According to Modern Healthcare, the sanctions have had a big effect on Medicare enrollment figures. As of March 31, Cigna enrolled 441,000 Medicare members, down 20 percent from the same period in 2016, just after the sanctions took effect. According to the 2017 Q1 report, revenue was also down 18 percent over the last year.

The Original story (published in 2016) …

Cigna Corp. announced on September 6, 2016 that it will not be able to offer new insurance plans during Medicare’s upcoming Annual Open Enrollment period.

Cigna said, in a notice filed with the U.S. Securities and Exchange Commission, that it’s still working with the Center for Medicare & Medicaid Services (CMS) to address audit findings that led to a Medicare plan sales ban in January of 2016.

“Cigna expects that these matters will not be resolved in time to participate in the 2017 Medicare Advantage and Part D annual enrollment period.”

In January of this year, CMS accused Cigna of running its Medicare plans in a way that threatened enrollees’ access to care. CMS prohibited Cigna from selling new Medicare plans in 2016, but allowed Cigna to continue to cover the people in the Medicare plans it had already sold.

CMS also has opened up the rules for anyone currently on a Cigna Medicare plan so they can change plans at any time. Cigna Plan Members in 2016 do not have to wait until the 2017 Medicare plan annual enrollment period which is set to run from Oct. 15 through Dec. 7th.

If you have a Cigna plan and want to review your options you can do that today and your new plan can start the 1st of next month! You do not have to wait until the end of the year!

If you have a Cigna Part D prescription Medicare drug plan and would like to find a plan that gives you better coverage or lower costs you can call 207-370-0143 and a licensed agent will review your plan choices with you.  There is no obligation to change plans and there is no cost for this help.  You can also call toll free: 866-976-9038 or fill out the online request HERE.

How to get the Generic EpiPen & pay less.

Blog Article, Medicare, Part D Prescription Drug Coverage

The drug company Mylan recently announced that it would roll out a new, generic version of its branded drug for just $300 per two-pack for commercially-insured patients.

Mylan has expanded it’s patient assistance program, which provides coupons and discounts to patients whose household incomes are four times the federal poverty limit.

The company’s generic version of the EpiPen is set to launch “in several weeks” and will be listed at 50% of the price of the brand name version, which has a retail price of about $600 per two-pack.  Aside from the cost, the generic version will be “identical to the brand-name product, including device functionality and drug formulation.”

If you have insurance with a high deductible, you will want to apply for their $300 savings card to access the generic EpiPen.  The “My EpiPen Savings Card,” as it’s called on the company’s website, will then “act as cash” at the pharmacy, bringing down the cost of your co-pay or co-insurance for a two-pack of EpiPens to no more than $300.  You can use the savings cards to purchase up to 6 two-packs per year.

Click here to get your card:  www.epipen.com/savings

If you have any questions or need help with the cost of your medications or would like reviewing your health insurance plan or Medicare Part D prescription drug plan, please send me a message using the CONTACT page or call me at (207) 370-0143.

If you don’t have an agent and would like one on your side then send me a message or give me a call.

You can reach me at (207) 370-0143 or by email using the form on my CONTACT page here.

“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

What to do when monthly premiums go up.

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Each year I hear from retirees in Maine and New Hampshire who have purchased expensive Medicare Supplement (Medigap) policies.  They have talked to a friend or neighbor who has worked with me and want to know why they are paying so much more.

If you have a Medicare Supplement then last year was particularly painful because there was no cost of living increase to your Social Security check yet the insurance companies still increased your rates.  And it looks like that will happen again this year with trustees projecting a 0.2 percent increase for 2017 and insurance premium increases are expected to be 3-5%.

So, what are your options?

Option #1 – Look at Medicare Part C (Medicare Advantage)

The first and most obvious choice for lowering costs is to look at Medicare Advantage plans, also known as Medicare Part C. These plans are required to offer everything that’s covered under Original Medicare, Part A and Part B, and may include other benefits as well, such as prescription drug coverage, dental, and vision.

These plans have much lower monthly premiums and unlike your Medicare Supplement the monthly premiums for Medicare Advantage plans have been going DOWN with a few plans now charging $0 per month.  These plans have cost shares that you pay when you go to the doctors or hospital but if you are only seeing a few doctors each year the savings can be big.

Click here to compare Medicare Advantage rates in your area.

Option #2 – Shop Around

Your second option is to shop around and find out if there is a less expensive plan that will suit your needs.  There are many plan choices that offer lower monthly premiums with more out of pocket costs.  If you have Plan F then you are on the most expensive plan available.

Look at the differences between Plan N, Plan G and Plans K or L to see of those would be better.  Be careful when changing plans and make sure you talk to your agent to make sure you are aware of all the costs.  Click here to compare Medicare Supplements in Maine and New Hampshire.

Option #3 – Change Insurance Companies

Another option is changing insurance companies.   Medigap plans are standardized and the coverage is identical from one carrier to another.  If you have Plan F with Company A and see that Company B is offering Plan F for less, you can switch to the lower cost plan and your benefits will not change.

Again, when changing plans it’s always best to talk to your agent to make sure you are aware of all the costs.  Click here to compare Medicare Supplements in Maine and New Hampshire.

Click here to contact me for more information on Medigap plans or more information on how to easily change plans.

Option #4 – Work with a local Independent Agent to help you.

Last but not least, if you are not working with a local agent then you should.  Unlike purchasing auto, home or life insurance, buying a health insurance policy is just the beginning, not the end of the process.  Why? Your health and that of your family can change constantly — and so can your insurance needs.

About 80 percent of what an agent does comes after you are enrolled in the insurance plan.  With health insurance, an agent remains your advocate. Since most people receive their health insurance through an employer before retirement, they see very little of the ongoing services that agents provide. To give a few examples, agents:

  • Assist clients with claim issues, and answer questions throughout the year.
  • Review rates and plan changes each year.
  • Explain plan designs, benefits and options.
  • Assist in resolving billing issues.

Licensed agents act as a single point of contact between you and the insurance company.  There is no cost to work with an agent.  Agents are paid in the form of a commission based on your enrollment in a plan.  These commissions are paid by the insurance company, not you!

“It really is a win-win situation for all my clients!”

If you don’t have an agent and would like one on your side then send me a message or give me a call.  I would love to help you save money!

You can reach me at (207) 370-0143 or by email using the form on my CONTACT page here.

“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

Scam Alert!

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There are two Social Security scams you need to watch out for at the moment.

The first one is where you receive an official-looking email from the Social Security Administration with an invite to create an account so you can receive your benefits. You land on a webpage where the scammers hope you will fill out all your confidential information. Don’t fall for it.

Never click on links in any of these emails. If you want to sign up for a My Social Security Account go directly to https://ssa.gov/myaccount/

Thomas Farrington of Maine Web Service, a provider of computer maintenance and security services advises, “It is a good practice to not follow links received in an email.  Instead, type the address in your browser to go directly to the site.  This is particularly important when going to a site where you enter any personal information.”

In the second scam, identity thieves obtain your personal information and use that information to open a ‘my Social Security’ account on SSA’s website. If successful, they then use that account to redirect your direct deposit benefits to an account controlled by the thief.

This should in no way discourage you from using SSA’s ‘my Social Security’ feature, which enables you to view your earnings history and estimated benefits.

in fact, establishing your account eliminates the risk of a new account being opened by an identity thief. This type of crime does, however, serve as a reminder to protect your personal information as you would any other thing of value. Once thieves have your personal information, they can use it to open credit accounts, buy homes, claim tax refunds, and commit other types of fraud.

Mr. Farrington’s advice when creating your MySSA account, is to go into the settings and choose the option that any changes to the bank account into which your check is electronically deposited only be done physically at a Social Security branch office and not using your online account.

If you receive information from SSA indicating that you have opened a ‘my Social Security’ account, and you did not open an account, you should contact Social Security so that appropriate action may be taken, and the matter may be referred to the Office of the Inspector General. You can do so by visiting or calling a local SSA office or calling SSA’s toll free customer service at 1-800-772-1213. Deaf or hearing-impaired individuals can call Social Security’s TTY number at 1-800-325-0778.

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