Give-Back or Buy-Back Plans

What are “Premium Buy-Back Plans”?

 

Is “too good to be true” always too good to be true?

Personally, I think things are NEVER too good to be true.

Good is always good!

I think it all boils down to what you believe. If you believe that there is no such thing as a free lunch, then you may never enjoy the gift of a free lunch.

If you believe that a free lunch could actually be free with no strings attached, that’s what you’ll receive. after all, food is everywhere and people can be very generous.

I personally believe it is a matter of personal beliefs and comfort level.   When you say that something is “too good to be true”, what are you really saying?  You’re probably actually saying that you don’t belive it.   

Next, ask yourself why don’t you believe it and you’ll probably discover that it’s because you don’t know enough about it to understand it. So you don’t trust it.

Education is the answer.

The unknown can causes a lot of anxiety.  Most people tend to stick with what they know, where they feel safe.

But risk takers are not people who go out and blindly jump on things.  They take the time to learn about new things and they usually end up with a better deal.  And everyone else comes around eventually.

10 years ago there were no Medicare plans under $50 per month.  Now there are many offering plans at $0 per month.  A lot of people thought these plans were “too good to be true” but they were the ones who missed out on saving that $50 per month and if they have not switched to a $0 per month medicare plan they probably will this year!

But wait.  $0 is not the best deal anymore.

 

There are some new plans entering the Medicare market in Maine and New Hampshire for 2019 referred to as “give-back” or “buy-back” plans.

…And that is exactly what they do.

These plans actually GIVE BACK a portion of your Part B premium!

Sound like a free lunch?  It just might be!

Every day as I meet with folks and help them understand their medicare options and at some point during every meeting someone asks, “What’s the catch?” which is often followed by “This is really too good to be true.”

Well it is all true!  This is Medicare!  And Medicare is great!

There are Medicare plans that cost $0 per month with no deductible – you’ve heard about them.  You may even be using one.

These plans are not “free” because you still must pay your monthly Part B premium ($134 in 2018) to Medicare so no one can say they are free. 

How can you get lower than $0?

These Buy-Back or Give-back plans cost $0 per month but in addition to that they will also buy back a portion of the Medicare Part B premium that you pay each month.

Medicare does not allow me give you specifics of any one plan but I can speak in general terms about the plans out there.  So, generally speaking these Medicare Advantage plans will send a set dollar amount ($25-$40) per month directly to Social Security which will reduce your Part B premium.  That’s $300-$500 they are giving you each year.

So Let’s do the math…

If they give you $300 each year and you see the doctor 4 times with a $5 copay and have 4 blood test with a $2 copay each and add a couple specialsts visits at $40 each then your total copays for the year are around $100.  That leaves you $200 ahead every year.  That’s right.  You MADE MONEY! 🙂

Is there a catch?

Of course, there’s always a catch.  You have to be enrolled in both Medicare Part A and Part B. 

Yep, that’s the only catch!

 

If you want to learn more about these plans contact me.  I can explain this over the phone or we can meet at your home and look at these plans to see if they will work for you.  I will never pressure you to change plans or convince you to switch.  That choice is completely yours to make.

I also do not charge anything to meet with you so what have you got to lose?  Just give me a call or send me an email by clicking the CONTACT button on the menu at the top of the page. 

I am always happy to help you!

 

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

How To Pay Your Medicare Bill

Do you receive a bill labeled Notice of Medicare Premium Payment Due?

If you did then keep reading to understand what this is and how you can pay it.

NOTE: If you receive benefits from Social Security, Railroad Retirement Board, or Civil Service your Medicare Part B premium will be automatically deducted from your benefit each month.

But …what if you have postponed your Social Security?

If you are not collecting your Social Security, Railroad Retirement Board, or Civil Service benefits, but you have enrolled in Medicare Part B, or if you owe a Part D Income-Related Adjustment (IRMA) then you will receive a notice from Medicare called “Notice of Medicare Premium Payment Due”.

You can expect to receive this bill around the 10th of the month. 

Here is a sample of what the bill will look like:

You can download this official brochure here:  https://medicare.gov/pubs/pdf/11659-Understanding-CMS-500.pdf

 

How Can I Set up Payment for My Medicare Premiums?

By mail

Follow the instructions on your Medicare premium bill and mail your payment to the address listed on the form.

Pay Online, through your bank

  • Contact your bank, or go to your bank’s website, to set up automatic payments.  Here is the Payee information you’ll need:
  • Your Medicare Number (It’s the combination of letters and numbers on your red, white and blue Medicare card.
  • The payee name: CMS Medicare Insurance
  • The remittance address:  Medicare Premium Collection Center, P.O. Box 790355, St. Louis, MO 63179-0355

Pay By Credit or Debit Card

  • Refer to the bottom portion of your Medicare bill and complete the instructions for paying by credit or debit card.
  • You’ll need your credit or debit card handy so you can fill in the account number and other information.
  • Mail your payment to the address above.

Sign up for “Medicare Easy Pay”

This is a free electronic payment option that auotmatically deducts monthly Part B premium payments from your savings or checking account each month.

To sign up go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4727.)  They are available 24 hours a day, seven days a week.

If you have questions about your bill or the status of your coverage call Social Security at 1-800-772-1213.

If your bill comes from the Railroad Retirement Board

The payee’s mailing address is: Railroad Retirement Board, Medicare Premium Payments, P.O. Box 979024, St. Louis, MO 63197-9000.

If you receive Civil Service retiree benefits

Contact the Center for Medicare & Medicaid Services (CMS) via e-mail at OPMMailbox@cms.hhs.gov or Call Medicare at 1-800-MEDICARE (1-800633-4227), 24 hours a day, 7 days a week.

Need Local Help? Have Medicare Questions?

I can help you!

Just give me a call at your convenience. My cell number is (207) 370-0143
or call toll free 866-976-9038.  Or send me an email using this online form;
 

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

 

Silver Sneakers or Reimbursement – Which is better?

Many Medicare plans offer benefits that help you stay healthy but each insurance company is different.

In Maine some Medicare supplement plans offer access to the Silver Sneakers program while others have chosen to be more flexible and offer gym membership reimbursements generally ranging from $100 to $300 or more per calendar year.

That’s right. They will pay you to go the gym!

The plans offering gym reimbursements are the most popular because they allow you to join the local gym that is nearby your home.

Tom Farrington owns Right Now Fitness in Westbrook, Maine and he says, “The most important thing about exercising is doing it!”

Tom says, “You have to show up and if you do then you’ve won. Even if all you do is walk 20 minutes on the treadmill or use a few weight machines, it is more than you would have done if you didn’t show up.”

Most of the membership at Right Now Fitness live local to Westbrook but Tom says that he also has members in nearby communities of Gorham, Standish, Buxton and Limington. He even has one member about 20 miles away in Saco. “One reason people choose our gym is because they work in Westbrook or because they drive by on the way to or from work.”

According to Tom, a big part of getting yourself to the gym is convenience, “If you have to travel out of your way to work out, you probably won’t do it.”

He’s right!

In comparing which fitness program is better, the final answer is … it depends.

If there are no gyms nearby that participate in Silver Sneakers then you should look at choosing a plan that offers cash reimbursements.

Another benefit to the plans that offer reimbursements is that some plans may also reimburse your costs of other wellness related services, such as excercise equipment for your home, the costs of working with a personal trainer, and even the costs of aerobic or yoga classes.

Wondering what your insurance plan offers?

If you are not sure if your Medicare plan offers one of these benefits you can contact the agent who helped you choose that plan or you can call me and I can help you and provide you will the forms you’ll need to fill out to get your money back.

If you are interested in finding out more about which plans offer these reimbursement or Silver Sneakers programs, you can use the contact page on this website to send me an email or I will be happy to help you over the phone. My number is 207-370-0173.

Best of all – it does not cost you anything!

I do not charge anyone for my help, whether you choose to work with me or not.  I get paid by the insurance companies that I am contracted with. I get paid for helping you and it does not cost you anything. You do not pay higher rates or any additional costs. You pay the same rate as everyone else whether I help you or not.

So, why not get some great advice and benefit from my experience?

You can 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 ahead of time to get you started. 
 
Book an appointment with Maine Medicare Options using SetMore
 
 
 
Have a question that needs to be answered right away?  Call me!
 
You can talk to me at (207) 370-0143
or call toll free 866-976-9038. 
Or send me an email using this form: https://www.mainemedicareoptions.com/contact
 
 
 

Are you turning 65 and still working?  Read this.

 

Moving to Maine?

Are you moving to Maine or another state, and enrolled in Medicare?

Moving can be a stressful time and you have a lot of things to change and update. You will want to make sure your Medicare and Social Security benefits continue smoothly so here is some important information that I hope will help make it easier.

First, what kind of Medicare plan do you have?

 

Lettered Plans (Plan G, Plan F, Plan N, etc…)

If you have a Medicare Part D Prescription Drug Plan, with a Medicare Supplement plan that is a “lettered plan” which works in combination with Original Medicare and you move to another state, you will most likely be able to keep the same supplement policy but you will have to change your Part D plan.

When to start shopping for a new plan.

If you’re enrolled in a Medicare Advantage plan under Part C of Medicare, a change in residence, such as moving to another state, could qualify you for a Special Election Period (SEP). During this period of time, you are able to find a new plan that is offered in your new home.

If you permanently move somewhere that your current Medicare plan does not cover (outside the service area), you should call your insurance company immediately and begin looking for a new plan. The phone number for customer service is located on the back of your insurance card.

If you call your insurance company before you move and tell them you are moving, you will have one month before the month you move and three more months after you move to find a new plan but your insurance company may end your coverage at the end of the month that you move. So be sure to ask when your plan will end.

If you notify your plan after you move, you can switch plans the month you provided notice of the move and up to two months after that. Again, your insurance company may end your coverage at the end of the month, so it’s important to ask when it will end.

Medicare Advantage or Part C

If your current insurance plan is not offered in the new area, your plan is required by Medicare to dis-enroll you.  If you don’t enroll in a new Medicare Advantage plan during your SEP, you’ll return to Original Medicare (Part A and Part B).

If you miss this window and do not choose a new plan before it ends you may have to wait for the Annual Election Period (October 15 – December 7) and your coverage will begin January 1st.

Medicare Part D Prescription Drug Plan

The same rules for the Medicare Advantage plans above apply to your Part D plan. If you don’t enroll in a new Medicare Prescription Drug Plan during your enrollment window, you might find yourself without Medicare prescription drug coverage, and you could face a Medicare Part D late-enrollment penalty if you pick up this coverage later on.

You may be able to enroll in a stand-alone Medicare Part D Prescription Drug Plan, or to get your Medicare coverage through a Medicare Advantage Prescription Drug plan – but if you don’t do it within a couple months of your move, you may miss your opportunity to change and would have to wait for the Annual Election Period (October 15 – December 7). Again, if you enroll in a new plan during this period your coverage will not begin until January 1st.

What if you move to an address that’s still within your plan’s service area, but where new Medicare Advantage or Medicare Prescription Drug Plan options are available to you?

This will also qualify you for a Special Election Period. You may use this SEP to enroll into the new plan that is offered in your new service area or do nothing and remain on your current plan.

When should I notify Social Security about my address change?

Make sure you notify Social Security of your change of address. The Social Security Administration handles Medicare enrollment. You can change your address by calling the Social Security Administration at 1-800-772-1213 (TTY users 1-800-325-0778) and speak to one of their representatives from Monday through Friday, from 7AM to 7PM. You can also visit the Social Security office nearest you and fill out a change of address form or visit them online at www.ssa.gov

How do I find a new plan?

You can use the Planfinder tool on the Medicare.gov website and put in your new zipcode and list out all your medications and the tool will give you a list of plans in that area that cover your drugs. This is just very basic information based strictly on the financial costs.

To find out the details on how the plans work and what doctors and hospitals accept the plan you will have to call each insurance company directly and ask the right questions.

Or …

You can call me and save yourself the time and headache. I will help you review all the plans available to you and I will explain each one and how it works. I have many clients who are using the different plans out there and I know from talking to them which plans have the best customer service and which are easiest to use. I can help you like I have helped all of them. Give me a call today. I will be happy to help you. My number is 207-370-0173.

Best of all – it does not cost you anything!

I do not charge anyone for my help, whether you enroll with me or not.  I get paid by the insurance company when I deliver your application so once we pick the right plan I will help you fill out the application and I will turn it into the insurance company for you. I get paid for helping you and it does not cost you anything. You do not pay higher rates or any additional costs. You pay the same rate as everyone else whether I help you or not. So, why not get some great advice and benefit from my experience?

You can 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 ahead of time to get you started. 
 
Book an appointment with Maine Medicare Options using SetMore
 
 
 
Have a question that needs to be answered right away?  Call me!
 
You can talk to me at (207) 370-0143
or call toll free 866-976-9038. 
Or send me an email using this form: https://www.mainemedicareoptions.com/contact
 
 
 

Are you turning 65 and still working?  Read this.

 

How To Cancel Your Obamacare plan

Hurray!

You are going to be 65 this year…

 

… and finally free from Obamacare!

 

If you are like most people you have been counting down the days to when you can leave the Obamacare system and enroll in Medicare.

When you are eligible for Medicare (which counts as qualifying health coverage) you are no longer eligible for a the advance payments of the premium tax credit and savings on out-of-pocket costs.

You should IMMEDIATELY end Marketplace coverage with premium tax credits or other cost savings when you become eligible for or are enrolled in Medicare

If you still want a Marketplace plan after you enroll in Medicare, you will have to pay full price for your share of the Marketplace plan without premium tax credits or other cost savings.

Note: Most Medicare insurance plans are less expensive than the plans on the Marketplace and almost all Medicare plans have no deductible!

When and how to end your Marketplace plan.

First you will want to enroll in Medicare (Both Parts A & B) about 3 months before your 65th birthday. You do this by contacting your nearest Social Security office or online at https://www.ssa.gov/medicare/

You can read more in-depth about When & How to Enroll in Medicare on this page: http://www.mainemedicareoptions.com/blog/how-and-when-enroll-medicare

STEP 1 – Enroll in Medicare (Parts A and B)

After you are enrolled in Medicare and you have received your confirmation letter from Social Security you will want to choose a Medicare Supplement plan or Medicare Advantage plan to replace your Obamacare plan.

Medicare is a complicated system and the insurance that works with Medicare is very different from the Marketplace plan that you have now. It is a good idea to meet with someone who can explain these plans and how they work.

You can compare Medicare supplement plans using the link below, but again, to really understand how these plans work and how those differences will effect you, it is a good idea to speak to a professional, licensed agent or broker in your state.

Click here to compare Medicare Plans: http://www.mainemedicareoptions.com/blog/compare-medicare-supplements

What if my spouse is under 65 and needs to stay on the Marketplace plan?

If both you and your spouse are on the same plan then the steps are basically the same with one additional step at the end.

STEP 2 – Enroll in a Medicare Advantage or Medicare Supplement

Once you are enrolled in Medicare you can then enroll in one of the many insurance plans available to Medicare beneficiaries. There are a lot of plans to choose from and once that choice has been made you will receive confirmation of your enrollment from your new Medicare insurance plan.

Step 3 – Cancel over the phone!

Trust me, I’ve been helping people through this process for a long time and calling is the best and easiest way to take of this.

Contact the Marketplace Call Center

at 800-318-2596

The Marketplace lists about 40 steps to cancel your plan online and even more if you want to leave your spouse on the plan and at the end of those steps they ask that you call to complete the changes over the phone.

So, why go through the hassle and frustration of doing the work online if you have to call anyway. Just call the Marketplace and explain that you are enrolled in Medicare and need your Marketplace plan to end. They will complete the changes for you over the phone. If you insist on doing it yourself, you can find the official instructions here: https://www.healthcare.gov/reporting-changes/cancel-plan/

Step 4 – Protect yourself!

It is important that while you are on the phone with your Marketplace representative that you make a note of the date and time of the call, as well at the name of the representative and any application ID numbers or reference numbers that the rep gives to you.

This information will be crucial should the Marketplace fail to notify your insurance company of the changes and they try to bill you for the months that you were also covered by Medicare. If you can prove you called to cancel prior to starting your Medicare enrollment they will be able to complete the dis-enrollment retroactively.

But if you are unable to provide the date you called the Marketplace or if you did not call the Marketplace to cancel you may be responsible for the monthly premiums for the time up until they cancel your insurance.

According to the current rules in 2018 (these rules have changed every year) your coverage will end on the last day of the current month if you call the marketplace to cancel your insurance on or before the 15th of the month.

If you call after the 15th of the month before you start your Medicare insurance then your coverage will end on the last day of the next following month. This is why is so important to begin this process 3 months before your 65th birthday!

If you are getting close to the 15th and you are getting nervous, please call me and I can offer you some advice on how to proceed. (207-370-0143) When I meet with clients who are transitioning into the Medicare system I make sure to help them with each step along the way so important deadline are not missed.

“Don’t try to do this online unless you’re ending coverage for everyone on the plan. It is important to do this by phone so your spouse can stay on the plan.” -phone rep on healthcare.gov

If you have any questions about this or need help making a change, I will be happy to help you.

And it won’t cost you anything!

I do not charge anyone for my help, whether you enroll with me or not.  I get paid by the insurance company when I deliver your application so once we pick the right plan I will help you fill out the application and I will turn it into the insurance company for you. It doesn’t get any easier than that!

You can 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 ahead of time to get you started. 
 
Book an appointment with Maine Medicare Options using SetMore
 
 
 
Have a question that needs to be answered right away?
 
Just give me a call at your convenience.  
 
You can talk to me at (207) 370-0143
or call toll free 866-976-9038. 
Or send me an email using this form –> https://www.mainemedicareoptions.com/contact
 

Did you choose the wrong plan last fall?

Did you choose the wrong plan last fall? 

You may qualify for a second chance to correct the mistake!

How can you Change your Medicare Advantage Plan?

There are a lot of rules around when you can change your Medicare Part C or Medicare Advantage Plan.

Most people know that you can enroll in or leave a Medicare Advantage Plan during the Annual Open Enrollment Period in the Fall which starts October 15 and ends December 7 each year. 

What most people don’t know is …

You can also leave your Medicare Advantage Plan (Part C) and go back to Original Medicare (Parts A & B) during the first 6 weeks of the new year.  This is called the Medicare Advantage Dis-enrollment Period.

You can only make this coverage change if you have a Medicare Advantage Plan. 

This Disenrollment Period occurs every year from January 1 to February 14.

And changes made during this period will become effective the first of the following month. For example, if you switch from a Medicare Advantage Plan to Original Medicare in February, your new coverage will begin March 1.

Why would you want to go back to Original Medicare?

Medicare Supplement plan benefits are standardized, which means Plan F is Plan F and Plan G is Plan G.  No matter which insurance company you choose to provide this plan the coverage is the same. But they all charge a different price.  [READ MORE…]

Perhaps your Medicare Advantage plan has some costs you were not aware of when you signed up or your plan changed this year.  Some of these changes may include; higher deductibles, higher monthly premiums, new restrictions on doctors, hospitals, and pharmacies that are different from last year.

Sometimes the cost of your prescription drugs may have increased or your anticipated costs of health care and hospital services has gone up. If you find you’re going to physical therapy or seeing a doctor more often then you may be paying a lot more out of pocket and this might increase as you get older.

Since Medicare Advantage plans are completely administered through a private insurance company, the rules and guidelines can vary between plans and from year to year, which can lead to restrictions like these:

Your Medicare Advantage plan may require higher out-of-pocket costs than with Original Medicare and these may increase each year as your health needs change.

The insurance company may require you to follow stricter rules to get coverage for certain services or health products, like getting referrals to see specialists or getting prior authorizations that delay necessary tests. You may also have to change your doctor or hospital to one within the new plan’s network, or you may have to pay a higher cost.

If you want to change, you can.  You just have to know when.

If you missed the February 14th deadline for the Dis-enrollment period, there are also certain circumstances that would make you eligible for a Special Enrollment Period (SEP) to change your health and or drug plan outside of the usual enrollment or dis-enrollment periods. 

If you qualify for a Special Enrollment Period, you may leave your Medicare Advantage Plan and your new Medigap or Supplement plan will start the first of the month after you sign up for or dis-enroll from the Medicare Advantage Plan. 

One example of when you qualify for an SEP: when your Medicare Advantage Plan leaves your area or you move out of your plan’s service area, you can switch to another Advantage plan or go back to Original Medicare and get a Medicare Supplement. Remember to enroll early during any enrollment period to make sure that your new coverage starts when it should.

If you have any questions about this or need help making a change, I will be happy to help you.  

And it won’t cost you anything!

I do not charge anyone for my help, whether you enroll with me or not.  I get paid by the insurance company when I deliver your application so once we pick the right plan I will help you fill out the application and I will turn it into the insurance company for you. It doesn’t get any easier than that!

You can 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 ahead of time to get you started. 
 
Book an appointment with Maine Medicare Options using SetMore
 
 
 
Have a question that needs to be answered right away?
 
Just give me a call at your convenience.  
 
You can talk to me at (207) 370-0143
or call toll free 866-976-9038. 
Or send me an email using this form –> https://www.mainemedicareoptions.com/contact
 
 
 

Are you turning 65 and still working?  Read this.

SSA not Deducting Premiums?

If you changed Medicare plans this year and received a letter from Social Security saying they will no longer deduct your Medicare prescription drug plan premiums from your monthly benefit, then this blog is for you.

So, What’s going on?

It’s January and if you changed your Medicare Part D prescription drug plan or your Medicare Advantage plan during open enrollment then you may have received a bill from the insurance company instead of having the monthly premium deducted automatically from your monthly Social Security check as it had been in the past.

What do you have to do?

When you changed your Medicare Part D prescription drug plan or changed your Medicare Advantage (Part C) plan you may have chosen to have the monthly premiums automatically deducted from your Social Security check.

But now you have received a letter from Social Security saying: “We will no longer deduct money for your Medicare prescription drug plan costs from your monthly benefits.”

This letter also says, “If you have any questions about your Medicare prescription drug plan costs, please contact your Medicare prescription drug plan.”

You should do just that!

Call the insurance company’s Member Services phone number (usually found on the back of your new insurance card) and they will instruct you to either pay your monthly premium by sending in a check (possibly with a coupon book) or set up automatic electronic funds transfer from your bank account (or a debit card).

This is because your new Medicare plan may not have had time to organize the automatic Social Security deductions and so you will be asked to use another form of premium payment.

But don’t worry. You can have it deducted from your Social Security payment. All you have to do is ask them to start having your monthly premiums deducted automatically from your Social Security check.

Please note: It can take up to three months to coordinate these automatic deductions with Social Security so you will need to continue paying your monthly premiums until then to avoid any lapses in coverage.

Want to know more?

The Centers for Medicare and Medicaid Services (CMS) has published a guide entitled, “Withholding Medicare Prescription Drug Premium from Your 2018 Social Security Payment” that outlines why some people are being denied automatic Social Security check deductions as their chosen form of premium payment.

You can download a copy of the document here: https://www.medicare.gov/Pubs/pdf/11400-Withholding-Medicare-Drug-Premium.pdf

This Medicare guide says that if you changed your Medicare Advantage (Part C) or Medicare Prescription Drug (Part D) plans, “depending on when you made your enrollment decision, you may be asked to pay your new plan directly for a while. If that happens, you’ll get a bill or payment book from your new drug plan telling you the amount you owe. Your new plan will expect you to pay premiums directly until premium withhold is started with your new plan. You may need to contact the plan to let them know you still want to have premium withholding.”

They continues with the example: “You enrolled at the end of Open Enrollment and chose to have your premiums withheld from your Social Security payment. However, you just got a payment book from your drug plan saying you owe $36.50 each month, starting in January 2018.

You call the plan, and the plan says that it didn’t get your request for enrollment in time to arrange for your January premium to be withheld. The plan says it will request to have the premiums withheld from your Social Security payment starting in February. You’ll need to send your premium payment for January directly to your plan.”

So some Medicare plans may not allow Social Security check premium deduction at the start of this year, even though this was chosen by you as the payment method on your application.

Instead, you will be told to either send the first premium payment by check or submit the Electronic Funds Transfer request. When you call the Medicare plan Member Services representatives they will send you the forms necessary to request the Social Security payment option – as per the new rule.

If you live in Maine or New Hampshire and would like more answers or if you’re looking for help choosing a Medicare plan or just have some questions, I would be more than happy to help you.

You can fill out this form to send me an email message or call me.

Please note: We are only able to give general information about Medicare related issues. If you have questions about your Social Security Benefit, please contact your the Social Security Administration directly.

Still have questions or want help comparing Medicare Supplement plans?  I can help you!

Just give me a call at your convenience. My cell number is (207) 370-0143
or call toll free 866-976-9038.  Or send me an email using this online form;

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

Medicare & Dental

Medicare’s coverage of dental care is very limited. Generally, Medicare will not cover preventative dental care, that is care you need primarily for the health of your teeth or your gums and jaw. For example, Medicare will not cover routine checkups, cleanings, or fillings, and will not pay for dentures.

Medicare will cover some dental services if they are required to protect your general health, or if you need dental care in order for another health service that Medicare covers to be successful. Such as dental services that are necessary for radiation treatment, or if you need surgery to treat fractures of the jaw or face, Medicare will pay for these types of “medically necessary” dental services. 

It will not, however, pay for any follow-up dental care after the underlying health condition has been treated. So, if Medicare paid for a tooth to be removed as part of surgery to repair a facial injury, do not expect Medicare to pay for any other dental care you may need later because you had the tooth removed, and Medicare will not pay for dental implants or dentures to replace the extracted tooth.

This is an unexpected reality for most people that I meet with who are leaving an employer insurance plan and have had dental insurance. When you’re used to your insurance covering these types of things it can be frustrating to find out that you will no longer have this coverage. But…

Some Medicare Advantage Plans Include Dental Coverage

There are a few Medicare Advantage plans available in Maine and New Hampshire that cover routine cleanings and other work at the dentist.  When it comes time for you to enroll in Medicare or during the Annual Open Enrollment Period (October 15th – December 7th in 2016) it is a good idea to review these plans if dental care is important to you.  Plans change every year and your plan may have added dental coverage and you may not know it.

Dental insurance is also an alternative.

You can get a free quote from Delta Dental by clicking here.(link is external)  The monthly premiums equal what most people pay out of pocket for their 2 cleanings each year so why not spend that money on the insurance now so when you need a filling you will have the coverage.   [Click here to see plans](link is external)

Dental Discount Plans are another popular option.

Discount plans are gaining in popularity.  For a yearly membership fee (roughly $10/month,) you can buy into a discount dental plan, which allows you to get some pretty significant discounts (up to 60% and 70%) and the only catch is that you use dentists that are in your plan’s network.  [Click here to see plans](link is external)

“Discount dental plans work like a BJ’s or a SAM’S Club membership,” says Edan Barshan, president of Universal Dental Plan.  In return for the membership fee, you can choose among a network of dentists who will give 15 to 60 percent rate reductions for certain services.  A $1,000 crown might only cost $600 for a member of a plan.”

“And unlike dental insurance, which may not cover preexisting conditions or have waiting periods, you can shop for a discount dental plan knowing you need a root canal and select the plan that offers the cheapest price,” says Buddy Johnson, chief executive officer of national discount dental provider DentalPlans.com(link is external).  “You could sign up today and go to the dentist tomorrow,” he says.

Dental discount plans differ in several ways from dental insurance plans:

  • Discount plans generally cost less than traditional dental insurance.
  • You have to pay for the service in full, or negotiate a payment plan with the provider.

There are generally no restrictions on how many procedures you can get at a discounted price in a given year. Discount plans generally run for one year, so you can switch plans as your needs change. If you have a dentist already, you should ask whether he or she will accept the plan. Otherwise, you’ll need to find a provider who will. A number of discount dental plans include elective services, which are often not covered by insurance plans. Cosmetic dentistry, for example, is almost always excluded by insurance, but cosmetic procedures like tooth whitening are included in many discount plans’ list of services. 

To search for discount plans in your area CLICK HERE(link is external) and put in your zip code.

As with any important financial decision, do your homework first.  Find out what providers in your area are on the plan and what procedures are covered.  Make sure that costs and benefits add up to a net plus for your particular situation.  And if you need help or have any questions just give me a call or send me an email.  I am happy to help you!

Would you like my help?

If you would like help finding the right dental plan or 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

Goodbye Obamcare!

Here is what you need to know if you are turning 65 soon and making the move from Obamacare to Medicare…

Your transition from your health insurance plan on the healthcare.gov marketplace won’t be automatic, but moving to Medicare doesn’t have to be difficult.

For decades people have been transitioning from individual coverage or group plans offered by employers onto Medicare but if you enrolled through the healthcare marketplace exchange or “Obamacare” as it is most often called, the process is a little different – especially if you are receiving the monthly tax credits that lower your monthly premiums.

If you are collecting your Social Security or Railroad Retirement benefits prior to age 65, the government will automatically enroll you in Medicare the month you turn 65.

If not, you will have seven months to contact your nearest Social Security office and enroll in Medicare.  Your initial enrollment period starts three months before the month you turn 65, the month you turn 65, and three months after, totaling seven months.

Most people pay no premiums for Medicare Part A, based on your work history. Medicare Part B has a monthly premium, which is $134 per month in 2017.

Beware: No automatic plan termination!

Prior to 2014, coverage in the individual market generally terminated automatically when you reached age 65. This changed under the Affordable Care Act. Now you need to contact the marketplace to cancel your coverage in order to make the move to Medicare.

Subsidies also end with Medicare eligibility.

You are not required to cancel your healthcare exchange insurance plan when you enroll in Medicare, but if you’re getting premium subsidies, they’ll end when you become eligible for Medicare.

Keeping an exchange plan might not be smart.

In almost every scenario, keeping your individual exchange plan along with Medicare would be a waste of money. The plans would provide duplicate coverage, and exchange plans are not set up to coordinate with Medicare.

Plus the most expensive Medicare plans are around $200 per month and have no deductible or out of pocket costs. So if you’re thinking of keeping it because you’re very unhealthy it just doesn’t make sense.

It makes even less sense if you are healthy! There are some plans that are actually $0 per month and have no deductible and the copays for doctors and specialists visits are very low. Ranging from $0 to $50.

When you’re ready to cancel your Obamacare health plan.

If you’re enrolled in a plan through HealthCare.gov, you can follow these directions for cancelling your plan so you can smoothly transition to Medicare. Or you can remove only yourself from the policy if you have other family members who need to stay on the exchange plan.

In Maine or New Hampshire, you’ll need to contact the Marketplace call center at 1-800-318-2596 or call your insurance agent or broker if you are working with one. If not, I can certainly help you. My number is 207-370-0143.

Helpful Tip: Cancelling your exchange coverage to switch to Medicare should be relatively simple, but I have seen cases where cancellation requests weren’t transmitted to the carrier in a timely manner. For that reason, I advise my clients to switch from bank draft to paper billing prior to submitting their cancellation request.

That way, if something goes wrong when the cancellation request is being processed, you won’t end up with premiums being automatically withdrawn from your bank account after your coverage was supposed to be terminated.

When should you cancel your plan?

My advice – to avoid any gaps in coverage – is to cancel call the Marketplace to cancel your plan 1 month before your Medicare begins. So if your Medicare starts January 1, you should schedule your exchange plan to terminate December 31st. It is best to call before the 15th of the month before you want your coverage to end.

Would you like my help?

If you would like to talk 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 does 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 pay nothing.

And you will not pay any more than anyone else and you are under no obligation whatsoever to change your plan 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

 

2018 Social Security COLA

Don’t wait for Social Security to give you a raise.

Give one to yourself!

How?  It’s Simple.

As the Medicare Part B premium increases each year and your cost of living increase from Social Security is $0 – this tactic might be one way to give yourself a raise! 

Ask yourself: Are you paying more than you have to for insurance?
Do you know what other people pay?

Most people who choose the Medigap type of Medicare supplement plan choose Plan F because it covers 100% of the costs left over after Medicare pays part of your doctor and hospital bill.  It’s easy to understand and easy for agents to sell. But it’s the most expensive of all Medicare supplemental plans!

The answer is to SHOP AROUND!

There is another plan (Plan G) 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 2017 is only $183.00.

That’s right, $183 is the entire deductible for Medicare Part B.

One of the big benefits to Plan G is lower monthly costs.

For example, several insurance companies are offering Plan G in Maine and starting in January of 2018 there will be more.

The lowest cost for Plan G is $165 and the lowest cost for Plan F is $206. This is a difference of $41 per month or $492 for the year!

That means after you pay the $183 Part B deductible you will save, $309 per year on Plan G!

Want to know more?

If you would like help reviewing these costs and comparing the different plans 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 or you can book a meeting online by clicking here. Book an appointment with Maine Medicare Options using SetMore

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.”

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