Garrett Ball, Owner, Secure Medicare Solutions

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Garrett Ball is the owner/president of Secure Medicare Solutions, Inc. SMS is a national, independent Medicare insurance brokerage that works with 40+ companies in 43+ states. SMS has been in business for 16+ years and worked with thousands of people going on to Medicare or already on Medicare.

As an independent, education-focused agency, our goal is to provide precise, easy-to-understand information about Medicare and Medicare plans, allowing potential clients to evaluate and ask questions on their own terms. Ultimately, this allows Medicare beneficiaries to make a prudent choice that fits their needs.

CONTACT GARRETT BALL WITH QUESTIONS OR FOR MEDIGAP QUOTES

About Garrett Ball

"We discovered Garrett Ball online. Over the years he has saved us thousands of dollars in premiums for both Supplemental Part B and Part D drug policies with his cost comparisons and advice. He is uniquely prompt in responding to our e-mail inquiries and very professional in all areas. Highly recommended for all Medicare needs." - Ron T, IN
" I am so happy to review this company and Garrett Ball, the President. He has helped me through the confusing maze of Medicare, Supplements, and Advantage plans and the plans I am on now have been outstanding. Do not hesitate to contact Garrett Ball. You will not be disappointed. Response time is within 24 hrs., and always with thorough information to help his customers. Even when I have not contacted him for many months, he seems to remember and respond like it was yesterday. Great customer service seems to be hard to find these days, that is why I am so impressed with Secure Medicare Solutions. You will truly find a solution to any of your questions or problems." - Sandy W, SC/FL
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Is Medigap Plan F Going Away?

By now, you’ve probably heard that Medicare Supplement Plan F (as well as Medicare Supplement Plan C) is being eliminated as of January 1, 2020. If you already have Plan F or C, or are thinking about enrolling in one of them, you should continue reading this!

For millions of Americans, Original Medicare is not enough to cover all their medical expenses. Thus, a vast number of seniors have supplemental coverage by purchasing a Medicare Supplement (Medigap) policy. Medicare Supplement (Medigap) plans are standardized across the board. plan f coverage chart

For many years, Plan F has been one of the front runners and best seller of these types of plans. In fact, over half of the people that have a Medigap plan have Plan F. Why? Well, because it is one of the most comprehensive of all the plans – its coverage includes all the deductibles, coinsurance, and copays that Medicare doesn’t cover. In other words, Plan F pays whatever would be your responsibility would be after Original Medicare pays its share. Policyholders of Plan F pay $0 for doctor visits, laboratory tests, surgeries, hospital stays, and more.

Plan F (and C) coverage includes the Medicare Part B deductible. This is called “first dollar coverage” – coverage is immediate, and benefits kick in without having to pay any sort of deductible. However, with this type of coverage, some studies showed (and legislators believed) that policyholders are encouraged to see their healthcare providers more often, since their plan pays for everything. This, it was speculated, put a burden on total Medicare spending.

Therefore, in 2015, Congress passed the Medicare Access and CHIP Reauthorization Act. This legislation prohibited all Medigap plans that cover the Part B deductible, to be sold to new beneficiaries on or after January 1st, 2020. Because of this law, Plans F and C will no longer be available to people turning 65 on or after 1/1/2020. The legislators believe that the existence of higher cost-sharing requirements would be an incentive for individuals to use fewer health care services. Hence, fewer doctor visits would lead to decreased overall Medicare spending.

What does this mean for you, if you already have Plan F or C?medigap plan g
If you are already enrolled in one of these plans, or you have a High Deductible Plan F, you can keep your plan. Enrollment is based on a guaranteed renewable basis; you won’t be denied coverage or cancelled – you will be “grandfathered” in. However, when that occurs, and the pool to new customers closes, the number of existing customers will become smaller. The smaller the number of customers, the less revenue is generated from premiums. In addition, the policyholder base within Plans F and C will be comprised of older individuals, not anyone turning 65. An aging policyholder base will likely lead to more medical expenses, claims etc. As a result, there is a likelihood that insurance companies will raise policyholder premiums more than normal.

If you have Plan F, you may want to reconsider your current plan and current situation. Switching to another plan might be a wise choice. A comparable option would be Plan G, which does not cover the Part B deductible ($185/year). It costs runs on average $25-$40 cheaper per month than Plan F premiums. In reality, Plan G has been the better deal for the last 5-10 years, as Plan F premiums have climbed at a faster rate than ‘G’ premiums.

When you figure out the amount of money you would be saving each month, despite having to pay the $185, you will probably come out ahead, financially. The coverage of that Part B deductible is the only difference between Plans F and G.

A consideration for switching to another plan is that you will have to be subjected to medical underwriting and answer medical questions when you apply. If you have any major health conditions or disorders, you may be declined. In that case, your best option would be to stick with your current plan. There are some states that have an exception to this requirement called the “birthday rule” (Washington, Missouri, California or Oregon give special annual enrollment periods to change plans).

What if I don’t already have Plan F or C, but want to enroll in one of them anyway?
You can still enroll in one of these plans until December 31, 2019. Please pay attention to the fact that you will have to pay the annual Part B deductible, which this year is $185. Also, you may be paying more for your policy in comparison to other insurance companies as explained above when Plan F closes its doors to new customers. paying for medicare part b

If you are turning 65, you should review pricing and coverage for various options before making your choice. If you are already on Plan F or C, you have less than a year to make your decision to switch or stay where you are. It might be an easy decision for you, or it might be more difficult. A lot can happen before next year regarding your health and finances, so it is prudent to weigh all of your choices from the various insurance companies and make an informed choice.

If you want a list of the plans that are available in your area, you can contact us online so we can send Medigap quotes via email. Or, you can call us at 877.506.3378.

Should You Use a Broker to Compare Medigap Plans?

The advantages of using a broker as opposed to doing the research yourself are:

  • Brokers are independent agents, who will give you their unbiased opinions about which Medicare Supplement plan to enroll in. They will explain all the various options to you, as far as which plan would be the best suited one for your situation and needs.  Some plans have more benefits than others and vice versa, and they will help you decipher between the advantages and disadvantages of each plan.medigap broker
  • The broker understands which Medigap companies have stability and what their credit ratings mean. They are well-versed in how to interpret these rating scales, and the stability outlook ratings as well. The broker is adept at breaking all this information down and explaining it in a clear, simple fashion. If you do the research on your own, you might not know about the AM Best or S&P ratings and skip them entirely.
  • The broker has experience and knowledge as to which companies have competitive rates and which do not.
  • The broker, possessing an in-depth knowledge of the industry, is aware of which companies are more reputable than others and can thus steer you in the right direction.
    guidance from medigap broker
  • The broker has the time and patience to do all the legwork for you. If doing all the work yourself, you might get overwhelmed and inundated (in fact, I’m sure you will!) by the amount of material you will have to sift and make sense of before you decide.
  • There is usually a back-office support team who can assist you and intervene on your behalf, when you have an issue or question regarding your Medicare Supplement plan. When you call a large insurance company, you usually get a call center and the customer service is not catered to you alone.  On the contrary, if you call your broker, the customer service you receive will most likely be more attentive and personalized, as you have already established a business relationship with the agency.
  • Most brokers (including Secure Medicare Solutions) do NOT charge a fee for their services (and there is no need to pay for a broker’s services).

Once you decide that you want to use a broker to help you find a plan, you need to ask yourself the question:  Do I want to enlist the help of a local or national broker?  The following comparison may clarify things for you.

  • A local broker can indeed assist you, but they are not always the most qualified. Location might be everything to some people, but the proximity of the agent should not be the decisive factor when buying a Medigap policy.  Nowadays, with streamlined technology being available, most applications can be completed using an online application process.  The client then reviews and signs the application electronically, and it is submitted in real time to the insurance company.  The application can also be done over the phone with the client.  As such, there is really no need for client face-to-face interaction.  You will have more access to a larger pool of brokers among which you can choose to work with. face to face broker
  • Some local brokers are not really brokers – they are “captive” agents who sell only the products of the company they work for. They might be considered employees of the company.  In this instance, the broker might not have the best of intentions.  He is restricted to selling only what the products that his company promotes.  Even if there is a better product available in the market, since he/she is held captive to that company, you would not have other options.
  • A broker must be licensed in the state in which is selling the Medigap plan. So please be wary of anyone who tries to sell you something that he or she is not licensed to sell or not for the state they are licensed to sell in!

The decision to go it alone or use a broker may be a tough one to make.  On the other hand, it may be an easy one for you to make, since you know exactly what you should do.  If you like doing research and are good at it, then forge ahead on your own!  But be aware that, to make a truly informed choice, you may have to call 30+ insurance companies that offer Medigap plans in your state.  If you want someone else to do the “heavy lifting” for you and explain all aspects of Medicare and Medigap so you can make an informed choice, then the best choice for you would be to let a broker do the work.

Choosing a Medicare Part D Plan – What Is Involved?

When you enroll in Original Medicare, you have two ways to get your drug coverage – you can enroll in a:

1)      prescription drug plan (PDP), otherwise known as Part D, as a stand-alone plan

2)      Medicare Advantage Plan (Part C), which includes a prescription drug plan, commonly known as an “MAPD” plan.  If you join a prescription drug plan while you are enrolled in a Medicare Part C plan, you will be disenrolled from that plan and return to original Medicare.

Please note that if you do not join a drug plan when you are first eligible, you may have to pay a late penalty.  There are, however, two instances that can exempt you from paying the penalty

  • You have other creditable prescription drug coverage, i.e. through an employer or union
  • You are currently receiving “Extra Help” – You may be eligible if you meet certain income and resource limits.  In this case, Medicare will help pay some of the costs of your prescription drug plan.

You must enroll in a drug plan which is run by an insurance company or any other private company. They also need to be approved by Medicare.

3)      Once you choose your drug plan, you can enroll by

–          going to www.Medicare.gov and enrolling on the Medicare Plan Finder

–          going on the plan’s website

–          calling the plan directly

When you sign up, you will have to give your Medicare number and effective dates for Part A and Part B.

How Do I Find a Medicare Part D Plan?

The best way to find a prescription drug plan is to follow the steps listed below:

  • Go online to Medicare’s website: www.medicare.gov/find-a-plan. You will then see a section, “Find Health and Drug Plans”
  • You can either use the general search option by putting in your zip code and then click “find”. Or for a more personalized search, you can enter your Medicare information.  More than one county may come up and in that case, just select your county
  • On the following page you will have to answer two questions
  • Then click on “Continue to Plan Results.”
  • You will see a box where you can enter your medications and dosages. If you have no more drugs to enter, then simply click on “My Drug List is Complete”.
  • Choose your preferred pharmacy (from the list or by zip code)
  • Then click on “Continue to Plan Results”; check “Prescription Drug Plans”; and “Continue to Plan Results, again.
  • The results are sorted from the lowest to the highest estimated annual cost (taking into consideration the medication premiums, copays and deductibles that you currently take and the pharmacy where you buy them. You can compare up to three plans at a time, which are printable.

Why Should I Compare Medicare Part D Drug Plans?

It is important for you to compare all the PDPs available to you to make sure you are getting the most value for what you will be paying.  Most seniors are on a budget, having to live on a fixed income and certainly want to find the best plan that is as inexpensive as possible.  Cost effectiveness is the #1 aim here.  The #2 in order of importance is that the drug company you choose provide the highest quality customer service and professionalism, along with excellent ratings and reputation.  Each plan’s benefits may vary regarding their copays, deductibles and premiums.  Most of the drug plans have deductibles but some do not.

It is advantageous to compare also because although a plan may have no deductible, they may charge more for your medications and ultimately not come out as the cheapest plan.

When comparing plans, you also should take into consideration the “Donut Hole” (coverage gap).  The Donut Hole is the portion of the plan where, after a certain point, you will be responsible for 100% of the costs of the medication). Some plans will give you a discount (Donut Hole Discount).  In 2018, the Medicare Part D plan coverage gap begins once you and your plan have spent $3750 on medications.  After this point, you pay no more than 35% of the drug plan’s covered costs for brand-name prescription drugs.  However, some plans may have higher savings, and that’s why you should do a comparison.  For more information on the Donut Hole, contact Medicare or go online at www.Medicare.gov/part-d/costs/coverage-gap/part-d-coverage-gap.html.

If you have chosen a PDP and you decide later that you would like to change it, you may only switch plans from October 15 to December 7 each year.  That said, there are special circumstances during a Special Enrollment Period, i.e. you are moving out of your plan’s service area; you are leaving your employer’s/union health coverage plan, etc.  Please note that if you have Medicare and Medicaid, you may change your prescription drug plan at any time during the year.

New Medicare Cards – What You Need to Know

The new Medicare cards are coming! With the Equifax security breach in the news, as well as other recent hacks of personal and sensitive information, this news could not come soon enough. Medicare will begin mailing out the new Medicare cards in April 2018.

new Medicare cards

FIRST LOOK! The new Medicare cards will no longer contain your Social Security number. Instead, they will have a random, unique sequence of numbers and letters.

Currently, Medicare cards contain a Social Security number on them with a letter at the end. The letter, by the way, indicates whether you are drawing Social Security yet, and whether your Social Security is based on your work history or that of a spouse, former spouse or deceased spouse. Most Medicare cards contain the Social Security number of the insured person.

In 2015, Congress passed a law requiring Medicare to change the way they identify Medicare beneficiaries on their Medicare cards. It’s a bit of an undertaking with Medicare having to assign all Medicare beneficiaries a new unique number and recreate 60 million Medicare cards. The rollout of the new Medicare cards will take place over a 12-18 month period, and it will begin in April 2018.

“We want to make this process as easy as possible for everybody involved,” said Seema Verma, the administrator of the Centers for Medicare & Medicaid Services, on a conference call Thursday.

Medicare has set up a website specific to the transition, will also be sending out handbooks related to this and has a call center to handle questions specific to the new Medicare cards.

So, what do you, as a Medicare beneficiary, need to know about the new Medicare cards:

  1. First and foremost, you should not do anything with your current card until you receive the NEW Medicare card. Keep using the current card, then once you receive the new one, replace the “old” card (the one with a Social Security number on it) with the new card (the one with the unique set of random numbers and letters on it).
  2. Be patient. CMS Head Seema Verma stresses that the rollout will START in April 2018 but it will carry over into 2019. We would expect it will last until late 2019. There has been no indication yet on how they will decide who gets the new cards first or what order they will go in.
  3. The new cards will be paper, just like the current cards (we know, it doesn’t make sense to us either!). $242 million just doesn’t buy you what it used to, I guess.
  4. Do not give anyone your current Medicare card or any information from it. Just like everything else that pertains to seniors, there is certain to be scams related to the new Medicare card rollout. To repeat, Medicare will NOT be asking you for your old Medicare card back or any information from it.
  5. When you receive the new Medicare card, take care to appropriately and effectively destroy the old one. Remember, it has your Social Security number on it. Burning it up may be taking it too far (but it is paper, after all). Whatever you do – cut it, shred it, burn it, flush it – make sure you leave no trace since it has your personal information.
  6. The new Medicare cards do not affect anything about your actual Medicare coverage. Your benefits will stay the same.
  7. If you have a Medicare Advantage plan instead of “original” Medicare, you will still get a new Medicare card (even though you don’t have to actually use it). Make sure you keep it in case your Advantage plan cancels you or you decide to go back to regular Medicare in the future.
  8. If you have a Medicare Supplement (Medigap) plan, you will also receive the new Medicare card but should not need to contact your Medigap company with the new information.

If you have any questions about this transition, or anything else related to Medicare, we are here to help. Feel free to contact us online or call us at 877.506.3378.

Do You Need Supplemental Insurance with Medicare?

What does Medicare cover?

Medicare, administered by The Centers for Medicare & Medicaid Services (CMS), is the largest health insurance program in the U.S. Created as a result of the Social Security Act in 1965, its enrollees account for about 40 million people.  Original Medicare does not pay for everything. Even if you are covered by Medicare Parts A and B, there will be some out-of-pocket expenses you may have to incur, i.e. copayments, coinsurance and deductibles, as well as travel outside the U.S. Original Medicare pays for 80% of your Part B medical expenses; the remaining 20% (of the Medicare-approved amount of the service, if the doctor or other health care provider accepts assignment) is your responsibility. That 20% gap could place a significant financial burden on you, resulting in very high out-of-pocket expenses.  There are no limits to the Part B 20% copays.  That is the reason why it is necessary to have a Medicare supplemental insurance plan in place.  This insurance is commonly referred to as a Medigap policy, its name implying its purpose to fill in the gaps where Medsenior staying healthyicare coverage does not exist.

There is usually no premium to pay for Part A of Medicare upon turning age 65, if you or your spouse paid Medicare taxes while working.  That is why this is often called premium-free Part A.  Important! To qualify for Medicare Part A and/or Part B, you must be a U.S. citizen or be lawfully present in the U.S. (be a legal resident of the U.S. for the last five years).

Part A covers the following:

  • inpatient hospital stays, including a semi-private room, meals, general nursing, drugs as part of your inpatient treatment and other hospital services and supplies.
  • physician’s fees
  • home health care – it covers medically necessary part time or intermittent skilled nursing care and/or physical therapy, speech language pathology services, and the need for continuing occupational therapy.  Your care must be ordered by a physician and it must be provided by a Medicare-certified home health agency
  • skilled nursing facilities,
  • hospice care – to qualify either a hospice doctor or your doctor must certify that you are terminally ill (life expectancy of 6 months or less).  After 6 months, you must be re-certified if you are still there.  Coverage includes pain management modalities, medical, nursing and social services, drugs, certain durable equipment, aide and homemaker services.  Hospice does not cover spiritual or grief counseling; stay in a facility (room & board) unless the hospice medical team deems it necessary for pain and symptom management; and the stay must be in a Medicare-approved facility.
  • critical access hospitals (small rural facilities)
  • inpatient care in a religious nonmedical health care institution.
  • blood – no charge except in cases where the hospital must buy the blood for you.  In that case, you must either pay the hospital for the first three units of blood you receive during the calendar year; or have blood donated by you or someone else.

Part B of Medicare is the medical insurance part.  It covers medically necessary physician’s services, i.e. x-rays, laboratory and diagnostic tests, flu and pneumonia vaccinations, blood transfusions, some ambulance transportation, and chemotherapy. In addition, outpatient care, physical and occupational therapy and some home health are also covered services.

Covered services also include the following:paying for medicare part b

  • Preventive screenings such as bone density tests, breast cancer screenings (mammograms), cardiovascular disease screenings and cervical and vaginal cancer screenings;
  • Clinical research studies
  • Mental health services
  • Surgical second opinions
  • Durable medical equipment (canes, walkers, wheelchairs, etc.), prosthetic and orthotics, surgical dressings, and therapeutic shoes and inserts.

According to the CMS website, coverage is equal to 80 percent of the lower of either the actual charge for the item or the fee schedule amount calculated for the item, less any unmet deductible. The beneficiary is responsible for 20 percent of the lower of either the actual charge for the item or the fee schedule amount calculated for the item, plus any unmet deductible.

What is not covered by Parts A and B of Medicare?

Medicare does not cover the cost of:

  • Routine dental care
  • Eyeglasses
  • Hearing aids and exams for fitting them
  • Acupuncture
  • Cosmetic surgery
  • Any type of custodial care for those who are unable to live independently.  That is provided you do not have an acute illness that would necessitate skilled nursing services.  For example, Medicare would not cover the medical expenses of someone in a nursing home who has Alzheimer’s or dementia, unless they suffered an acute illness, i.e. heart attack or pneumonia.
  • Long-term services
  • Concierge care (retainer-based medicine, boutique medicine, platinum practice or direct care).

In summary, supplemental insurance can help most people enrolled in Medicare pay for the things that are not covered by Medicare.  It covers the “gap” that Medicare Parts A and B do not cover.  The additional expenses can be quite substantial and become a financial burden to seniors.  Although Medigap plans have standardized benefits regulated by the Federal Government, it is very important to note that costs can vary from company to company, even though the insurance and the coverage is the same.  So, choose a plan wisely!

When Is the Medicare Open Enrollment Period?

When is the Medicare Open Enrollment Period?

The Medicare Open Enrollment period is terminology that many people often use to refer to the end of the year period during which you can change medical and prescription plans. However, there is definitely some serious confusion about this period and some misuse of the term. This is, at least in part, due to the enormous amount of marketing the insurance companies do during this time of year. So, let’s clear up the Medicare open enrollment period confusion.medicare open enrollment period

Medicare Open Enrollment: When You First Turn 65 or Start Medicare

The actual Medicare open enrollment period is when you first turn 65 or go on Medicare Part B. During this time period, you have open enrollment into a Medigap (Medicare Supplement) plan. This open enrollment period lasts for 6 months starting with the first day of the month you turn 65 (or your Part B effective date if that date is later). During this time, you cannot be made to answer any health questions or undergo any medical underwriting to be approved on a Medigap plan.

Likewise, when you turn 65 or start on Medicare Part B, you have an initial election period, during which you can select a Part D plan (prescription drug plan) without restriction or penalty. This initial election period lasts for 7 months – the month you turn 65 and three months on either side of that month. During this time, you can select any Part D plan without restriction or penalty.

If you are opting to go with a Medicare Advantage plan, you get the same initial election period as detailed above – 7 months including the month of your 65th birthday and three months on either side of that month.

So, What is the Annual Medicare Enrollment Period?

The period that occurs annually, at the end of each year, is actually the “annual election period” or AEP. This period does not apply at all to Medigap policies (Medicare Supplements). On the contrary, this period only applies to Part D and Part C (Medicare Advantage).medicare annual election period and open enrollment

The annual election period runs from October 15 to December 7. During the AEP, you can make changes to your Part D prescription drug plan or your Part C Medicare Advantage plan. Any changes that you make will take effect at the start of the following calendar year.

Many people often mistakenly think that you can also make unrestricted changes to your Medigap plan during that period; however, that is not the case. While you certainly can compare and change your Medigap plan during that period, you do still have to answer medical questions and be approved. It is not, technically, an open enrollment period for Medigap plans though. And, you can compare Medigap plans and change your plan at any time of the year.

How to Prepare for the Medicare Annual Election Period?

If you have either a Part D plan or a Medicare Advantage plan (Part C), you will receive a notice of plan changes for the following year in the mail. This usually comes in late September or early October. It is crucial not to merely disregard this mailing. Some of these plans change drastically each year, and you don’t want to get stuck in a deteriorating plan.

When you receive your notice of plan changes, you should look over it carefully. It should show a side-by-side comparison with the previous year’s benefits. See what changes have been made and decide, based on the plan changes, your satisfaction with your plan, and any changes to your health or finances, whether you want to “shop” for a new plan.

If you do want to shop for a new Part D or Advantage plan, keep in mind that you can only do so during the annual election period, which runs from October 15 to December 7.

Secure Medicare Solutions is a leading, independent Medicare insurance agency. We work with the companies that do Medicare Supplement plans so that you can compare all options in a centralized, unbiased place. We also provide Medigap quotes online by email and can answer any questions that you have. You can reach us at 877.506.3378 or online.

Should I Pay a Doctor’s Bill If I Think Medicare Should Have Paid?

Have you ever received a bill from a doctor’s office that you thoughtmedicare should have paid was incorrect? Maybe an incorrect amount – or maybe even a bill that you thought that Medicare should have paid and your Medicare Supplement should have paid? This seems to be happening more and more with Medicare beneficiaries, to the point that I hear about another instance of this every week or two from my clients.

Hear are the three steps that I recommend taking if/when this happens to you:

  1. First of all, DO NOT just pay it right away when you get it if you think Medicare should have paid. No matter what the facility says about sending you to collection, damaging your credit, showing up at your door to get the money, etc., if you don’t think you owe it or that something is incorrect, don’t pay it. Many providers rely on third-parties for medical billing, and the reality is that they make mistakes. It can be difficult to recover money paid after the fact, so before you pay it, move on to step 2 and investigate it.
  2. If you get a bill that you think is incorrect, you should pursue investigating it. Did they bill both you and Medicare? Did Medicare pay but they billed you anyway? If one of these things happened, it does not necessarily mean there was something illicit going on, but you should always investigate it. The best/first way to do this, in my experience, has been to call Medicare (1-800-MEDICARE) to find out if they received a bill for the date of service in question. They should be able to very easily look up that date and tell you if they did. If they did, they can also tell you if they paid it, or if they didn’t, why they didn’t pay it. That is a good starting point. From there, you know what to say when you call the doctor’s office.Keep in mind that Medicare Supplement plans (Medigap) pay when Medicare pays and do not pay when Medicare does not pay. So if Medicare did not receive, or did not pay, a bill then your supplement company would never have any received the Medicare crossover request to pay their portion.medicare should have paidAnother tip as you investigate – make sure to record date/time that you called and who you speak with.
  3. After you call Medicare itself and the provider’s office, you should have some answers to what happened or how it can be fixed. Sometimes, it’s as simple as a coding error on the claim. Other times, the provider’s office could have billed you while waiting for Medicare’s payment. Regardless, you should certainly pursue it and not blindly pay a bill that you don’t think is your responsibility.All this said, it’s possible that the bill IS your responsibility. Keep in mind that Medicare does not cover anything it considers experimental or not medically necessary. Also, traditional Medicare does not cover preventive dental or vision.

If this happens to you and you are one of our clients, please call us. While Medicare will not give us information about your claims, due to HIPAA regulations, we can do a three-way phone call or guide you through the steps to finding a solution to the problem.

 

Why Should You Use an Independent Broker to Choose a Medigap Plan

There are several options for comparing and enrolling in a Medigap plan. First, you can contact each company that offers plans in your area to compare plans and rates. Although this is certainly an option, it is one that would be incredibly time-consuming. The alternative is using an independent broker – an independent broker allows you the opportunity to compare multiple options in a centralized place, get unbiased feedback about the various plan options and make an informed choice.

Often, people end up choosing a plan that is higher in price than other options, without understanding the standardization of plans which mandates that all companies offer the same coverage and work the same way. This can lead to paying more for the exact same thing. An independent broker’s job is to help you compare the options to pick a plan that is competitively-priced for the coverage level you want.

If you have questions about this or want to look at the options in your area, please contact us online or call us at 877.506.3378.

Current Trends in Medicare and Medigap Insurance

The only thing that is certain in regards to Medicare and Medigap insurance is change. Each year, deductible amounts, premiums, coverage, etc. all change on both “original” Medicare (Parts A & B), Part D (Rx coverage) and Medigap plans. Add to that the changing marketplace for medical insurance in general, and you have a lot to keep up with.

We’ve put together a rundown of some of the changes/trends we see today, in early 2016, which may be helpful.

  • First of all, the Medicare Part B premium has changed for people who are “aging in” to Medicare in 2016. In most cases, if you already had Part B, you get the benefit of the “hold harmless” provision, which keeps your Part B premiums at the same level as they were in 2015. But for new beneficiaries in 2016, the premium is $121.80/month.
  • The average Part D premiums for 2016 increased to $41.46 (up 13% from 2015 numbers!). Of course, with Part D, you have to look at the whole picture of how a plan covers your medications. But still, this change is significant. Approximately 83% of people are paying more for Part D in 2016 than they did in 2015.
  • There are fewer Part D plans available. Part D options peaked at an average of 55 per state in 2007. Since that time, the number of available options for Part D in each state has steadily declined. Currently, there are an average of 26 plans in each state. Fewer options means less competition.
  • Likewise, there are fewer Medicare Advantage choices. In some areas of the country, they are down to 1-2 companies offering plans. This, coupled with lower reimbursement rates (the Federal government pays these plans) has further reduced the benefits offered by these plans. This is a trend we would expect to continue and possibly expand in the next couple of years.
  • More companies are entering the Medigap marketplace. Last year, in 2015, there were 3-4 large insurance companies that began a foray into the Medicare Supplement market. Some were more successful than others, but overall, this greater level of competition in most areas has led to increased price competition and lower (compared to past years) rate increase percentages.
  • Plans G and N are grabbing a larger portion of the Medigap market share. Plan G rates, in particular, have been more stable than ‘F’ rates in recent years, so although the Part B deductible (which ‘G’ doesn’t cover) has gone up, Plan G continues to attract more customers.
  • More and more Medigap companies are offering a husband-wife discount, and many companies are expanding that to be a household discount, available even if both spouses do not have a plan with the same company.
  • The “donut hole”, or coverage gap, for Medicare Part D continues to reduce in size. As part of the ACA legislation, the Medicare “donut hole” is being reduced each year, leading up to its eventual elimination in 2020.
  • The number of doctors that are accepting Medicare patients has seemed to stabilize, according to a Kaiser Family Foundation study. This may/may not be attributable to the recent “doc fix” legislation, which was passed in April to avoid a proposed 21% cut in doctor reimbursement rates.

If you have questions about any of this information or want to speak with someone directly, you can call us at 877.506.3378 or reach out to us online on our Facebook page or Contact Form.
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Garrett Ball is the owner/president of Secure Medicare Solutions, Inc, a leading, independent Medicare insurance brokerage. We are licensed in 43 states and have helped thousands of Medicare beneficiaries navigate the Medicare maze over the last 8 years.

Medigap Rates Online – Can You Get Them and How?

A common question is whether you can get Medigap rates online. Many people are surprised to learn that it is not as easy as you think it should be. In general, you can get some Medigap rates online; however, you don’t always get complete or accurate information. This article explains why and gives you options for obtaining a Medigap comparison.

First of all, as a preface, while you may not get complete or accurate Medigap rates online, you certainly can easily get a complete, unbiased Medigap comparison by email. As far as getting a listing on a website of all plans available to you, with rates customized to your age, gender, zip code, situation, etc., it’s not that easy.

There are three main factors that make it difficult to get Medigap rates online. First, some companies do not allow their rates to be published online by agents. This greatly inhibits your ability to get an accurate picture of the plans available in your area. Second, some Medigap companies only deal with “captive” agents that only represent/sell plans for that one company. “Captive” agents wouldn’t be able to give you rates for other companies besides their company, while independent brokers wouldn’t have rates for “captive”-agent companies. Lastly, companies have different rates for each zip code and age and are changing rates all the time, making Medigap rates online possibly unreliable/out of date.

So, with the unavailability and unreliability of Medigap rates online, what are the other options? The good news for the Medigap consumer is that you don’t have to have a pushy agent come to your house or spend hours on the phone with companies or insurance agents. The easiest way to get Medigap rates online is via email. You can easily get rates delivered directly to your inbox that are both customized to your age, gender, zip code, situation, as well as accurate, reliable and prompt.

Secure Medicare Solutions can provide that service – Medigap rates by email. The important thing here is to make sure you are requesting the information from an independent broker/agent. This way, you can compare all options in a centralized place. There are likely other companies that will provide similar information as well, but most or all require a phone number and address as well in order to contact you with phone calls, mail, etc. Particularly if you are someone turning 65 or ‘shopping’ for a Medigap plan, the last thing you want to do is give someone ELSE permission to call you endlessly. Getting Medigap rates by email solves that problem – gather the information, read at your leisure, compare plans and make a sound, unbiased decision.

If you have questions about this process or want to speak with someone directly, you can contact us using the form here or by phone at 877.506.3378.