Should you buy direct or use an agent?

 
If you are reading this then you are most likely in the process of deciding not only if you need insurance, but whether you should enroll direct with the insurance plan online or meet with an insurance agent or broker.  A recent survey asked consumers which they were inclined to use.  When asked if they preferred to buy insurance online or from an agent, the first response was “online.”
 

The top three reasons given were:

  • Save money by cutting out the middleman
  • Ease of transaction
  • Speed of transaction

The survey then asked participants to use both methods to purchase insurance.

The results:

Save money by cutting out the middleman:
The study found that consumers rarely saved enough money to warrant bypassing an agent or broker’s help.  Rates are the same for everyone whether you enroll direct or get help from an agent.
 
Ease of transaction:
While the online experience was easier at first than direct contact with an agent, most agents were far more proactive in asking important questions that would allow them to give better recommendations, particularly when participants had multiple questions that required follow-up.
 
Speed of transaction:
The survey was evenly split regarding speed. Direct-to-consumer websites delivered fast results for the length of time required to sit down with an agent, while agents took more time with fact finding and matching a consumers needs to specific products.  However, the speed differences reversed when it came to making changes in coverage, documentation requests, and additional questions – agents were far more efficient and easier to reach for follow up.
 

Consumers who were part of the study also found that comparing insurance plans was not so simple.

Personally I was not too surprised when I read this study because I meet with people all the time who say they wish they had known about me years ago.  “You could have saved me so much time and money,” they’ll say.    
 
Comparing health insurances (especially Medicare Advantage plans & Medicare Prescription Drug plans) is very complicated and you really need someone who has experience and knows a lot about how these plans work.   As a broker I talk to my clients regularly about their experiences with the different insurance companies.  If one of them is not doing something right I hear about it.   The other benefit to working with an agent or broker – like myself – who is contracted with multiple insurance carriers is that they can help you with comparing plans so you can find the best plan for your needs.  To do this on your own you would have to meet with a representative from each insurance company and then they will only tell you the positive aspects of their plan.  You will have to discover any shortcomings as you experience them. With anything as significant as purchasing health insurance it’s always best to have someone on your side.
 
Just remember that there’s no one right insurance plan, or one perfect way to shop for something as important as insurance. The bottom line is that you need to identify your priorities, do your research, and find the best plan for your needs. You might be able to do this on your own, or you might need the help of a trained professional to make these decisions.
 
 

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

 

 

Changing from Obamacare to Medicare

If you are currently enrolled in a Healthcare Marketplace plan and receiving monthly premium tax credits, be aware that you will no longer qualify for those credits when you turn 65 and are eligible for Medicare.

If you have a Marketplace plan now, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.

When to apply for Medicare

Once you are eligible for Medicare (at Age 65), you’ll have a 7 month Initial Enrollment Period to call Social Security and enroll.  This 7 month initial enrollment period begins 3 months before the month you were born, the month of, and 3 months after your 65th birthday.
In most cases it’s to your advantage to sign up for Medicare when you’re first eligible because once your Medicare Part A coverage starts, you won’t be able to keep any premium tax credits or other savings for a Marketplace plan based on your income. You’ll have to pay full price for the Marketplace plan.
If you enroll in Medicare after your initial enrollment period ends, you may have to pay a late enrollment penalty. In addition, after your initial enrollment period ends you can only enroll in Medicare Part B (and Part A if you have to pay a premium for it) during the Medicare general enrollment period (from January 1 to March 31 each year).  AND your Medicare coverage doesn’t start until July of that year.  This may create a gap in your coverage if you do not keep your marketplace plan and continue paying full price for the cost of the insurance.

Learn more about how and when to enroll in Medicare.

If you want coverage to supplement Medicare, you can get Medicare supplement (Medigap) insurance. You cannot supplement Medicare with a Marketplace plan. It’s against the law for someone who knows that you have Medicare to sell you a Marketplace policy. This is true even if you have only Medicare Part A or only Part B.

Learn about other Medicare options, like Medicare Advantage Plans.

Canceling your Marketplace plan

To cancel your plan online, follow the instructions that best describe your situation:

“I’m the only member of my household enrolled on my Marketplace plan. You’ll simply terminate the whole application.”

How to end coverage for everyone on your application

  1. Log into “My Account” at www.healthcare.gov
  2. Select “Visit the Marketplace for Individuals and Families.”
  3. Select the application you want to end coverage.
  4. On the far left side of the screen, select “My Plans & Programs.”
  5. Scroll down and select the red button that says “End (Terminate) All Coverage.”
  6. Select an effective date to end your coverage that’s at least 14 days from the current date and click the attestation.
  7. Select the red “Terminate Coverage” button.
  8. A red “Cancelled” or “Terminated” status should appear above the plan you ended.
You can also end your plan by phone at 1-800-318-2596 (TTY: 1-855-889-4325)
Available 24 hours a day, 7 days a week.

“My spouse and I are both enrolled in the same Marketplace plan, but only my spouse needs to cancel due to getting Medicare. I want to keep the Marketplace coverage for my spouse and end Marketplace coverage only for myself.”

How to end coverage for anyone other than the Applicant:

  1. Log into “My Account” at www.healthcare.gov
  2. Go to “Report a Life Change.”
  3. Select “Add or remove member of household” and then click “Continue” twice.
  4. Continue clicking “Save & Continue” until the “You’re applying for health coverage for these people” page.
  5. Select the “Remove” button for the person you’re removing from Marketplace coverage and continue through the application. Note: You must complete steps 5 and 6 for each person you want to remove from Marketplace coverage.
  6. On the household information screen, add the removed spouse or dependent’s information if they are still a member of your household.
  7. Click the green “Continue to Enrollment.”
  8. Complete the steps to choose or confirm a health plan. Note: Only the people who are still eligible to enroll in a health plan through the Marketplace will be asked to choose or confirm a plan before confirming enrollment.

In most cases, when you end coverage for only some people on your application, your coverage ends immediately.  Be sure not to cancel your Marketplace plan before your Medicare coverage begins. Otherwise, you may have a gap in coverage.

IMPORTANT NOTE:  When you end coverage for just some people on your application, their premium tax credit or other savings may change. You may need to update your household income after ending coverage for one or more people.

Becoming newly eligible or ineligible for premium tax credits or changes to other cost-savings may qualify them for a Special Enrollment Period.

You can also end your plan by phone at 1-800-318-2596 (TTY: 1-855-889-4325) 
Available 24 hours a day, 7 days a week.

Would you like my help?

If you would like to talk to someone about your options or schedule a meeting at your home or a nearby meeting place, you can call 207-370-0143 or use this form to ask a question.

The best part about working with me is that it will not cost you anything to meet and 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.

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

Call me toll free at (866) 976-9038 or call direct at (207) 370-0143.

I look forward to hearing from you!

Book an appointment with Maine Medicare Options using SetMore

Beware Observation Status!

Every year, thousands of Medicare patients who spend time in the hospital for observation but are not officially admitted find out they are not eligible for rehab in a nursing home after they are discharged.
Medicare rules state that you must spend 3 consecutive nights (midnights) in the hospital (not counting the day of discharge) as an “admitted” patient in order to qualify for nursing-home coverage. If you are under observation but not admitted, you will also lose coverage for any medications the hospital provides for pre-existing health problems. (Medicare drug plans are not required to reimburse patients for these drug costs.)

Some background on “observation” status.

Medicare beneficiaries who are under observation (which is considered outpatient care) often face higher out-of-pocket costs, including higher co-payments and charges for drugs that are not covered for outpatient stays.
The rule says that to be eligible for Medicare’s nursing home coverage, you must spend three consecutive midnights “admitted” in a hospital.  This means that days spent under “observation” do not count towards meeting this requirement.
Since an observation stay is an outpatient hospital stay is it covered under Medicare Part B (the medical insurance part of Medicare).  If you have Original Medicare, Part B covers outpatient services you receive and you typically pay 20 percent coinsurance for each medical service you receive in the hospital after you have met your yearly Part B deductible.
If you get your Medicare benefits through a Medicare Advantage plan, different costs and rules may apply. Each plan is different.  You will need to contact your plan directly to learn more about your plan’s coverage of hospital care.  It is important to know whether you are considered to be a hospital inpatient or an outpatient since your Medicare costs and coverage may be different depending on your status because your costs may be higher if you are a hospital outpatient.

If you are in the hospital, you or your family member should ask hospital staff whether you are an inpatient or an outpatient each day during your hospital stay, since this affects what you pay for hospital services.  Keep in mind that whether you are an inpatient or outpatient can also affect whether you will qualify for Medicare coverage of skilled nursing facility care.

However things are about to change – but only slightly!

Last week President Obama signed a new law passed by Congress called the “NOTICE Act”.  This new law will require hospitals to tell you of your outpatient status within 36 hours, or, if sooner, upon discharge.
Hospitals will have until next year (August 2016) to comply with the new law.  So you still need to be aware of your status when you or a loved on is in the hospital.  Nothing is changing today and once this law is implemented hospitals still have 36 hours to notify you so I would continue asking about your status daily so you are aware.

“The new law will not cure [some] problems, but will at least give patients a warning before they spend thousands of dollars on care that will not be covered by Medicare,” Jeff Marshall, an elder law attorney in Pennsylvania, said. “Some beneficiaries will likely decide to receive a different set of medical services after being notified of their observation status.”
If you would like to know how your plan pays for inpatient vs. outpatient care you can contact your plan by calling the phone number on the back of your insurance card or by calling 1-800-Medicare.   You may also contact us for a plan review to find out if you are getting the coverage you need at costs that are affordable to you.   Remember, Medicare Advantage plans and Medicare Prescription Drug plans change every year so it is always a good idea to review these changes and to look at what other plans offer to make sure you’re taking advantage of all your options.  

Would you like my help?

If you would like to talk to someone about your options or schedule a meeting at your home or a nearby meeting place, you can call 207-370-0143 or use this form to ask a question.

The best part about working with me is that it will not cost you anything to meet and 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.

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

Call me toll free at (866) 976-9038 or call direct at (207) 370-0143.

I look forward to hearing from you!

Book an appointment with Maine Medicare Options using SetMore

SilverSneakers in Maine

The SilverSneakers Fitness program is an insurance benefit.

Through this program health insurance plans provide a gym membership to their members, usually at no additional cost.  A SilverSneakers membership allows you access to more than 13,000 participating locations nationwide, and includes all the basic amenities plus group exercise classes geared specifically towards the active older adult. Members get access to amenities such as fitness equipment, pools and saunas, SilverSneakers classes designed specifically for active older adults and led by certified instructors, guidance and assistance from a “Program Advisor” and other fun social activities.  If you are enrolled with one of these insurance companies all you need to do is call the toll free number on the back of the card and ask a Member Services representative to help you identify which facilities in your area are participating and how to get your SilverSneakers card. You can also order your card online at https://tools.silversneakers.com/Eligibility/GetCard

Which insurance companies offer this program?

You can check here to see if your current plan is listed:  https://tools.silversneakers.com/Eligibility/HealthPlans?state=ME.  If not, then keep reading…

When Can You Enroll?

Every year in October, the insurance companies release their new offerings and plans.  Sometimes a plan will add this great program for their members but it does not always get communicated clearly that it is available.  I can contact you in October with an updated list of the insurance plans that offer the Silver Sneakers program.  But to do that I would need your permission.  I do not send unsolicited email or call people unless they have asked me to call.  Click here to request an update.  Also, if you would like to change your insurance to a plan that would give you more options I am able to help you with that process as well.  I work with all the top health insurance companies that offer plans in Maine and New Hampshire.
I work very hard to educate people about all the different options available so they understand all the benefits and can make the best decision about which plan to choose.  I would be happy to sit down with you and go over these details or help you compare other health plans. When it comes to understanding the differences in these plans I work very hard to make sure my clients are well taken care of.  Open enrollment for Medicare begins Oct. 15th in 2015 and with that will come the familiar deluge of promotions and conflicting advice about how much you could be saving by changing your plan. I am here to help you sort through it all. Pose your questions by clicking here.
When contacting Maine Medicare Options, you understand you may be directed to a licensed insurance sales agent.

Longer Life Expectancy with Increased Fitness Level.

Studies have shown that older adults with even a moderate fitness level have a longer life expectancy than physically inactive seniors. Moderate levels of physical activity can help reduce the risk of heart attack and stroke, lower cholesterol levels and blood pressure, improve balance and flexibility, and reduce back pain, among many other benefits. Seniors who remain physically active experience less disability and a higher quality of life than those who lead a sedentary lifestyle. In fact, the older you are, the more you need to exercise regularly.
Silver Sneakers is a safe, fun program that provides a wide variety of options for this kind of beneficial exercise, especially designed for seniors. More than 40 Medicare plans offer this benefit to seniors across the nation, with over 11,000 gyms, fitness centers, YMCAs and Curves facilities participating. If you belong to SilverSneakers, you have access to basic fitness center memberships at any participating location, as well as special fitness classes, activities, and health and nutrition education designed for older adults. Whether your goals are to lose weight, increase strength and stamina, improve flexibility and range of motion, or just to remain physically and socially active, a SilverSneakers membership can help you reach those goals.

Silver Sneakers Locations

Silver Sneakers locations are chosen for their safety, accessibility, amenities, and overall welcoming environment. They have a variety of fitness equipment available, varying by location. Members may have access to weight machines, free weights, treadmills and other cardio machines, pools, saunas, and even whirlpools. To become a certified SilverSneakers participating location, each gym has to go through an extensive process to show it is capable of providing the level of access, guidance and support that older adults need to exercise safely and effectively. Each participating location also has a trained Program Advisor who is usually available Monday through Friday to help you make the most of your SilverSneakers membership.
As well as providing equipment for independent exercise, SilverSneakers locations provide classes that can be components of your membership. These fitness classes are specifically designed for older adults, and taught by certified instructors who are specially trained in leading fitness programs for aging adults. All SilverSneakers class instructors undergo an in-person training and evaluation process. They are all CPR-certified, and are trained in the procedures to follow in case of emergency.

Silver Sneakers Classes

Silver Sneakers classes range from 45 minutes to an hour in length, vary in intensity, and offer multiple formats to fit your personal needs and interests. You can choose from Muscular Strength and Range of Movement, Cardio Circuit, Yoga Stretch, and Silver Splash (available at locations with pools). Depending on which classes you choose to participate in, you can increase your muscular strength, endurance, range of movement, flexibility, balance, agility and coordination.
Social interaction can be almost as beneficial to the health and well-being of older adults as is exercise. SilverSneakers programs offer ongoing activities like potlucks, raffles, dances, and speaker events, providing a good variety of options to add to your social calendar.
Life is too short to waste it feeling unwell, lethargic, or afraid to do things because you feel weak or brittle or unsure of your balance. Get out there and get active. You will be amazed at what you can do in and out of the gym after taking advantage of the SilverSneakers program.

SilverSneakers & Medicare

Now here comes the good news:  many Medicare insurance plans cover the full cost of the SilverSneakers  program!  That means you get gym membership for free.  Not all Medicare Advantage insurance plans offer the SilverSneakers program.  Please check with your medicare insurance company to see if they offer SilverSneakers.

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

Medicare Enrollment – Timing

How to Correctly Plan Your Enrollment

Most people getting close to retirement know that Medicare coverage starts when you turn 65.  But that’s not the whole story. If you want to enroll in Medicare without hassles and costly penalties, you need to know exactly when to sign up for the program you want. There are different enrollment periods, so it’s trickier than you might think.

   …it’s trickier than you might think.

Not everyone needs to sign up at age 65. You may still be covered by your employer’s health care plan, for example, or if you are eligible for Medicare due to a disability, you can actually sign up earlier.

Initial Enrollment Window

Medicare has established a seven-month Initial Enrollment Period, which includes the three months before you turn 65, your birthday month, and the three months afterward. This window applies to all forms of Medicare—Part A (hospital), Part B (doctor and outpatient), Part C (Medicare Advantage), and Part D (prescription drugs).

Medicare Supplement (Medigap) Enrollment

There is a separate six-month open enrollment period for Medicare Supplement policies (also called Medigap), which begins when you’ve turned 65 and are enrolled in Part B. During this period, insurers must sell you any Medigap policy they offer, and they can’t charge you more because of your age or health condition. This guaranteed enrollment period may be crucial because if you miss this window and try to buy a Medigap policy later, insurers may not be obligated to sell you a policy and may be able to charge you more money.

General Enrollment

If you missed enrolling in Part A or B during the Initial Enrollment Period, there is also a General Enrollment Period from January 1 through March 31 each year. Waiting until this period could, however, trigger lifetime premium surcharges for late Part B enrollment, which can end up costing you thousands of dollars more. Also your coverage won’t begin until July!
Part D drug coverage may not be something you need when you first retire.  But if you don’t sign up for it when you are first eligible, and later decide you want it, you will face potentially premium penalties (surcharges).  For example, if you missed enrolling during your initial enrollment period and then bought a policy, a premium surcharge would later take effect if you were without Part D coverage for 63 days.  And this surcharge is added to your premium for the rest of the time you have a Part D plan.

Special Enrollment Periods

There are lots of special conditions that can expand your penalty-free options for when you sign up for Medicare. And there also are what’s called Special Enrollment Periods for people who’ve moved, lost their employer group coverage or face other special circumstances. These special periods may have enrollment windows that differ in length from the standard ones.

If you’re turning 65 and still working click here to learn more.

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

Low Cost Insulin Alternatives

Medicare Part B covers some diabetes supplies, including:

  • Blood sugar (glucose) test strips
  • Blood sugar testing monitors
  • Insulin
  • Lancet devices and lancets
  • Glucose control solutions  
  • Therapeutic shoes or inserts

Note:  You may need to use specific suppliers for some types of diabetic testing supplies.

If you’re diabetic then you know how expensive it can be. 

While Medicare provides testing supplies to monitor your blood glucose levels at no cost the drugs to treat diabetes are covered under Part D so there is a cost associated with these medications.   Insulin and the syringes to administer self-injections are very expensive and often times can contribute to you entering the “donut hole” which means these drugs get even more expensive.

READ MORE ABOUT THE DONUT HOLE HERE

If you find yourself unable to afford your insulin or syringes or if you do not have Medicare yet here are some tips on how to get what you need.

Blood Glucose Test Strips

If you don’t have insurance or Medicare, test strips are obscenely expensive and the cost seems to be getting worse every month. Still, used properly they can be the most powerful tool you have in the battle to avoid high blood sugar levels and the damage that can cause.

The ReliOn brand meters and strips sold at Walmart are much cheaper than the name brand strips. Currently you can get a box of 50 test strips for about $9.00. (http://relion.com/products/relion-prime-blood-glucose-test-strips-50-ct)

Type 2 Diabetes Drugs

With most pharmacies and supermarkets selling generic drugs for $4 per prescription, you can afford these effective diabetes drugs.

The most prescribed drug for people with Type 2 diabetes is Metformin. Plain Metformin and Metformin ER, the extended release form that is easier on the stomach, are both available as generics. Some generic brands appear to be stronger than others, so if you aren’t happy with the results you are getting with one brand, ask the pharmacist to try another, or if that isn’t a possibility, switch your prescription to another pharmacy that dispenses a different generic brand. The pharmacist will tell you which brand they dispense if you ask.

Insulin

Analog insulins which most doctors prescribe are very expensive. The ones I see prescribed most often are Lantus, Levemir, Humalog, and Novolog. Fortunately there are other insulins that are much cheaper which you may be able to use instead. These cheap insulins are sold at Walmart under the ReliOn brand name.  Currently a vial of ReliOn Novolin is $24.88. (http://relion.com/products/?subcategory=insulin)

The pharmacy at Walmart also has a 100 count box of syringes for $12.58. (http://relion.com/products/relion-insulin-syringes-0330g-mis) as well as a 50 count box of Pen Needles for $9.00 (http://relion.com/products/relion-pen-needles-32g4mm)

 

CAUTION:  Always consult with your doctor before switching medications.

Ken Inchausti, director of media relations, communications and public affairs for Novo Nordisk, Inc., which is the maker of Novolog warns, “There are going to be some distinctions,” he says. “… You can have variations in terms of, one NPH is constructed this way, one NPH is constructed another way.”

Most doctors recommend any time you are switching medications in any situation, it requires delicate and close monitoring and care to make sure you will have a consistent outcome. Always consult with your doctor before switching medications.

The patient information sheet for Humulin states in bold capital letters: “Any change in insulin should be made cautiously and only under medical supervision. Changes in strength, manufacturer, type (e.g., regular, NPH, analog), species or method of manufacture may result in the need for a change in dosage.”  Likewise, printed on the Novolin box is the warning: “Any change in insulin should be made cautiously and only under medical supervision.”  The same warning appears on the website for ReliOn.

What if the cheap insulin is not for you?

If these cheaper insulins are not an option for you for whatever reason, ask your doctor to file the paperwork to get insulin via one of the hardship programs that help people who are insulin dependent. If he cannot or will not, call the largest regional hospital in your area and ask to speak to a social worker about how to sign up for one of these programs.

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 go to the CONTACT page of this site to send an email message to me.  

Call me today and I will explain all your options and help you understand those options so you can get the coverage you need for the most affordable price.

Call me today at (207) 370-0143 or toll free at (866) 976-9038.

 

If you have VA coverage do you need Medicare?

We often get folks asking us this question. And the answer is yes.  With coverage through the Veterans Administration you should also enroll in Medicare Part B and you might also want to consider adding a supplement plan.

The Department of Veterans Affairs strongly urges everyone who gets VA health care to join Medicare Part B upon reaching age 65. By doing so, you broaden your health insurance coverage and receive many potentially valuable health care benefits. Here are some of those:
  • Medicare Part B insurance helps pay for doctors’ services and outpatient care. It will cover you if you have an emergency and are taken to a non-VA hospital. Without Part B, you might have to pay some of those costs yourself. In future years, you also may have need to use medical providers outside the VA system. Those costs would be covered by Medicare.
  • VA medical care depends on an annual congressional appropriation. There’s no guarantee that the VA will always receive enough funds to provide care for all veterans.
  • Although the VA is not permitted to bill Medicare for the care it provides you, it is allowed to bill your Medicare supplemental (Medigap) insurance plan. If you have both Medicare and a Medigap policy, it could provide you with valuable health insurance package.
  • As a low-income person, you may be able to get help paying your Part B premiums through the state-run Medicare Savings Program. Go to this Medicare webpage to find out which agency in your state runs the program.

You can discuss your situation both with Social Security at 1-800-772-1213 and with the Veterans Administration health benefits office by calling 1-877-222-8387 toll-free. Don’t be surprised if they both urge you to enroll in Part B as soon as you’re eligible.

Click here to read more about when to enroll in Medicare.

Do you need additional Coverage?

Whether or not it’s a good idea for you to purchase additional health insurance may vary based on your proximity to the nearest V.A. Medical center.  It is our experience that all veterans should at least consider it. If one lives close to the V.A. they can often get a Medicare Advantage plan which will allow them access to other doctors and hospitals outside the V.A. at a small copay or cost sharing amount without having to always go to the V.A. and in turn it does not effect that coverage. Some of these plans also over $0 monthly premiums which means if you do not use it then it costs you nothing.  We also recommend these plans to our more rural folks to help offset the medical costs that can be incurred.
Not every situation is the same, but we do feel taking a look is certainly in your best interest even with V.A. medical coverage. Call me today and I will explain all your options and help you compare plans so you can choose the coverage you need for a price you can afford.

Call me toll free at (866) 976-9038.  Call right now.

I look forward to hearing from you soon!

Book an appointment with Maine Medicare Options using SetMore

Looking for a new Doctor?

5 Things to Consider When Searching for a New Primary Care Physician. (PCP)

1. Ask Around

If you know a doctor, nurse, pharmacist or dentist, ask for the names of doctors or practices in your area whom they like and trust. That can be more insightful than recommendations from friends or family. You should also consider what kind of doctor you want. Maybe you need someone who can care for your whole family or someone who focuses on women or seniors?
 

2. Make sure your new doctor is “In-Network”

Often times your insurance is an HMO (Health Maintenance Organization) and uses a network of doctors to provide care.  Some insurance plans do not cover visits to doctors outside of this HMO network so use your insurance carrier’s physician directory. (They will provide a printed copy if you call and request it.) Or search on their website for doctors in their HMO network. If you are working with an insurance agent or broker they can also help you determine which doctors are in network and even help you change to a more flexible plan so you can see the doctor you choose.

 

Here are the top insurance plans in Maine and their search sites for in-network doctors. (Because doctors often add or drop plans, call the office to verify that the doctor still accepts your insurance.)

 
 

3. Location Location Location!

I chose my doctor based on convenience.  My doctor’s office is 6 miles from my home so it’s easy to fit it into my schedule either in the morning on my way to an appointment or in the afternoon on the way back.  Sort your list of in-network doctors by location and check out which one’s are nearby.  Also look at their office hours – what days and times can the doctor see you?
 

4. Meet the Doctor

Most doctors will offer a 15 min consultation visit (generally at no charge) so you can get a feel for whether you’ve selected the right doctor. Discuss any current medications you are taking and your medical history to be sure you are on the same page when it comes to managing your health.  Also ask about office policies.  Ask how long it takes to make an appointment for a routine visit (it should be less than a week), whether they offer same-day appointments, and how long patients are kept in the waiting room. Once you’re a patient, if the reality doesn’t meet your expectations, consider shopping around. That’s important not only to save you time but also for your health. In practices that waste patients’ time, research shows that “patients are less likely to follow up on recommendations to prevent or manage chronic conditions,” said L. Gordon Moore, M.D., chief medical officer at Treo Solutions, a data analytics firm.1
 
NOTE:  While you are making the initial phone call to meet your potential new doctor and when you arrive at the office notice how they treat you and other patients in the office.  They are the people who will schedule your appointments, check you in and out, give the doctor your messages, and address insurance concerns. Look for a staff that’s friendly, efficient, and respectful.
 

5. Remember to Factor in Technology

Many doctors now use email or an online portal to communicate with patients, which may be another important thing to ask. Electronic health records let your doctor track your medical history, share info with specialists, and monitor all of your drugs. A patient portal is a secured website that gives you 24-hour access to your health information, allowing you to book and track doctor appointments, get lab results, request prescription refills, and e-mail questions to your doctor. The government requires that health information be protected with passwords, encryption, and other technical safeguards. Still, it’s a good idea to ask how your information will be safeguarded.
 
Many people looking for insurance choose to meet with someone who can help them find which plan is best for them.  Choosing between the many different types of insurance plans is a difficult decision.  What is the best plan for you may not be the best plan for your partner or spouse.  
If you would like me to come to your home and meet with you one-on-one please Contact Me.  My phone number is (207) 370-0143 or call me toll free at (866) 976-9038.  I am available anytime to chat.  There is no obligation to you and no cost to meet with me.
 
 
 
1 Source: October 2014 issue of Consumer Reports on Health. 

When and How to Enroll in Medicare

It’s always best to start early because the rules and deadlines for Medicare enrollment can be confusing. Here’s what you need to know…
 
Firstly, Medicare has two parts: Part A, which is your hospital coverage and has no monthly premium for most people, and Part B which is your Medical coverage (doctor’s visits and other medical services).  Part B costs $104.90 per month for most enrollees in 2015.
 

When to Enroll in Medicare

 
Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later.
 
You can enroll any time during the Initial Enrollment Period (IEP), which is a seven-month period which starts three months before your 65th birth month, includes the month of your birth and three months after. It is a good idea to enroll when you are first eligible (three months before your birth month) to make sure your coverage starts when you turn 65.
 
If you miss this seven-month sign-up period, you will have to wait until the next “General Enrollment” which starts each year on January 1st and runs through March 31.  Your Medicare benefits will begin the following July 1st. You also might incur a 10% penalty for each year you wait beyond your initial enrollment period, which will increase to your monthly Part B premium by the penalty amount.
 

Still Working and Have Employer Insurance?

 
If you are eligible for Medicare and still working then you may have an exception to the penalty. If you have group health insurance coverage through your employer or your spouse’s employer, and the company has 20 or more employees, you have a “special enrollment period” in which you can sign up. This means that you can delay enrolling in Medicare Part B, and are not subject to the 10 percent late-enrollment penalty as long as you sign up for within eight months of losing that coverage.  This would generally happen when either you or your spouse eventually retire.
 

Part D Drug Coverage

 
Original Medicare does not cover prescription medications, so if you don’t have creditable drug coverage from an employer or union, you’ll need to buy a Part D drug plan from a private insurance company during your initial enrollment if you want coverage. Some health plans include drug coverage and some do not.  You will want to compare each of your options carefully because drug prices and co-pays can vary between different companies.  If you don’t enroll in a Part D prescription drug plan when you are eligible you’ll also have a penalty.  This is 1 percent of the average national premium ($33.13 in 2015) for every month you don’t have coverage and will also be added to your monthly premium at the time you enroll in a plan.   So, even if you do not take any medications it is wise to consider the plans available weigh the costs of the plan with the eventual penalty you may incur.
 

Medicare Supplements

 
When you enroll in Medicare it is also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B to help pay for things that aren’t covered by Medicare, such as co-payments, co-insurance and deductibles. 
 

“All-In-One” Plans

 
Instead of getting original Medicare, plus a stand-alone Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan that covers everything in one plan. These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper monthly premiums, but their deductibles and co-pays are usually higher which makes them better suited for healthier retirees.
 

How to Enroll

 
If you’re already receiving your Social Security benefits before 65, you will automatically be enrolled in Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have group health coverage through an employer that qualifies you for late enrollment without a penalty.  If you’re not receiving Social Security, you’ll need to enroll either online at http://www.ssa.gov/medicare/, over the phone by calling Social Security Administration 800-772-1213 or through your local Social Security office.
 

Help is Available!

Finding a trusted source for help can be frustrating, with all the “noise” generated from mailers, TV ads and radio spots. My name is Todd Reagin, a Licensed Insurance Agent specializing in Medicare plans for residents of Maine and New Hampshire. I actually qualify as a Broker because I’m independent, and I represent the top Medicare insurance plans in Maine and New Hampshire.  
 
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 go to the CONTACT ME page of this site to send an email message to me.  
 

Best Part: It Will Cost You NOTHING!

 
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 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 when we meet.  Everyone needs help because there are so many different plans to choose from and I want to help.  I have found great joy in being able to offer my services to people who want my help.
Book an appointment with Maine Medicare Options using SetMore

Call me today and I will explain all your options and help you understand your options so you can choose the coverage you need for a price you can afford.

Call me today at (207) 370-0143 

or toll free at (866) 976-9038.  

Call right now. I’m waiting! 🙂

 
 
  
 

 

Medicare Supplement Plan G vs. Plan F

Are you paying more than you have to? 

More often than not, Plan F is the “go-to” plan when considering a Medicare Supplement.  However, Medicare Supplement Plan G is a great option that many seniors don’t know about because some agents don’t understand how it works so they don’t explain it.  To make it easy, let’s start by looking at how they’re similar.

Plan G and Plan F actually have a lot more in common than your agent may think.  In fact, they provide identical coverage.  The only difference between the two options is the Medicare Part B deductible. Plan G does not cover the Part B deductible, which is $183 in 2017.  However, there can often be more than a $200 difference in the annual cost of a Plan F versus a Plan G. 

Here are some things you should know about Plan G:

  • You receive the same coverage with Plan G as you would with Plan F.
  • Plan G has fewer guaranteed issue situations than Plan A, C, and F, rewarding you with more stable rate increases.
  • Even though with Plan G you will pay the Medicare Part B deductible, often you will save more in monthly premiums by choosing Plan G over Plan F.

How do you know if Plan G might be right for you?

When the annual premium difference between Plan F and Plan G is more than the Medicare calendar year Part B deductible, choosing Plan G would actually save you money!  If you are willing to pay the Part B deductible out of pocket, Plan G might be right for you.

Still have questions?  

Give me a call at (207) 370-0143 or toll free (866) 976-9038.  

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

 

 

 

 

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