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

South Carolina Medicare Supplement Plans M and N

June 1, 2010 marks an important day for Medicare Supplement plans in South Carolina and the rest of the country. The South Carolina Medicare Supplement plans are changing for the first time since 1992. We have addressed some of the changes in our previous post, which can be seen here: The 2010 Medigap Changes.

Possibly the change with the effect on the largest amount of people is the addition of Medigap Plans ‘M’ and ‘N’. These plans are totally new to the marketplace and have never before been offered. In fact, nothing like these plans has been sold as a Medigap plan previously. We’ve outlined the coverage that will be offered in those plans below, as well as what we believe to be the benefits of these plans, when compared to existing Medicare insurance options.

Plan ‘M’
Plan ‘M’ will be very similar to the current Plan ‘D’. It will still cover the 20% not covered by Medicare at the doctor’s office, hospital and skilled nursing facility. However, it will use cost-sharing in exchange for lower monthly premiums. The insured will be responsible for 50% of the Part A deductible, which is currently $1068 per benefit period. Current plans either cover the Part A deductible fully or not at all. Most people expect that the premiums for Plan ‘M’ to be about 15-20% less than current Plan ‘F’ premiums.

This plan may be a good fit for those who currently have a Medicare Advantage plan, that is terminating coverage or that they are leaving. Many of those individuals are used to having a hospital deductible, and with Medicare Advantage premiums expected to go up next year, Plan ‘M’ premiums project to be very close to Advantage plan premiums anyway.

Plan ‘N’
Plan ‘N’ is the second of the two new Medigap plans. This plan is also similar to the current Plan ‘D’, in that it covers the 20% that Medicare doesn’t cover at the doctor, hospital and skilled nursing facility. Instead of using a deductible method, like Plan ‘M’, this plan will use cost-sharing through co-pays to keep premiums lower. Insureds will have a co-pay at the doctor’s office of $20 and a co-pay of $50 for emergency room visits. This plan projects to have premiums that will be 30% less than current Plan ‘F’ coverage.

Just like Plan ‘M’, the expected market for Plan ‘N’ is the Medicare Advantage customers who are either losing or dropping their current coverage. Plan ‘N’ can definitely be a valid alternative for those losing or dropping this coverage, but who want to avoid Plan ‘F’ premiums.

Overall, the 2010 Medigap changes offer many benefits to those on Medicare+Medicare Supplement insurance, through additional benefits and new plan options. We get asked all the time how health care reform will affect them and their Medicare. While it remains to be seen what will happen with that and how it will effect those on Medicare, the 2010 changes have already been announced and everyone who has a Medicare Supplement should educate themselves about how this will affect them.

Health Care Reform – How Will It Affect Medicare?

Even if you wanted to, you cannot escape the talk of health care reform these days. It is everywhere in printed, online and television media. As a leading, independent resource for Medicare and Medicare insurance news, Secure Medicare Solutions has closely examined both sides of how the proposed bill will affect those on Medicare. Our goal is to give you an unbiased look at how some of the proposed changes will affect you and your Medicare and/or Medicare insurance.  

Proposed Reform: Better Pricing for Part D Drugs
How it Affects You: This is a proposed change to assist in regulating the pharmaceutical industry and controlling drug prices. Medicare Part D aims to do this by negotiating better overall prices for Part D drugs, which should, over time, reduce the Part D premiums and co-pays that Medicare-eligible individuals have to pay. Some headway has been made on this already, with the pharmaceutical industry agreeing to a 50% cut for those that reach the dreaded “donut hole” (details for this are still pending).

Proposed Reform: Reduce Medicare Payments to Private Insurers (Medicare Advantage)
How it Affects You: If you have been paying much attention to the health care debate, you have heard the Medicare Advantage program mentioned numerous times. The projected change is to base the payments to these private insurers on an average of the plans’ bids, rather than the system now which is a standardized government-set amount. For those on Medicare Advantage, this reduced funding will, most likely, lead to an increase in premium and/or reduced benefits. For everyone on Medicare, it should lead to the ability to reduce the Medicare Part B premium.

Proposed Reform: Link Payments to Hospitals to Hospital Performance
How it Affects You: The idea to link hospital payments for Medicare patients to hospital performance has been around for a while, and it is a major part of the proposed health care reform. It’s intention is to increase overall hospital efficiency and give hospitals an economic incentive to “do right” by the patient. Some feel that this will lead to greater efficiency at hospitals, while others believe it will lead to greater dishonesty and fraud within the system. If it is a part of any legislation that is passed, we’ll find out for sure!

Proposed Reform: Standardization of Payments to Skilled Nursing Facilities/Long-term Care Facilities
How it Affects You: This provision of proposed legislation is intended to cut waste in the current Medicare system by measuring actual costs to come up with a more uniform system for reimbursing these facilities through Medicare. It remains to be seen if this will affect the quality of care received if in one of these facilities; however, the overall goal is to reduce waste in this part of the system and reduce the cost of Medicare to all Medicare-eligible individuals.

Proposed Reform: Reduce/Regulate Fraud, Waste and Abuse in the Medicare System
How it Affects You: This is the proposed reform that most everyone can agree upon. There have been many ideas tossed around as to how to do this. One of the primary ways that this is projected to be accomplished is higher scrutiny of health care providers and hospitals. Additional pre-payment reviews will be implemented, particularly on doctors/hospitals that order a significant amount of high-risk or high-cost procedures. Over time, this is intended to reduce the cost of Medicare (Part B premium, etc) to the individual.

Regardless of which side of the debate you come down on, it is obviously important to keep an eye on how it will all play out and how it will affect you. At Secure Medicare Solutions, we will do our part to keep you updated on any changes. You can always get updated information and follow along with us at Secure Medicare Solutions: An informative Medicare Insurance and Medicare Supplement Blog.

South Carolina Medicare Supplements — When is Open Enrollment?

I get asked this question all the time: “I have a Medicare Supplement. When does that open enrollment period start again?” When you have employer-sponsored insurance, as many people do during their working lives, you get accustomed to having a certain period of the year in which you can make changes. Plus, you are inundated with the Medicare Advantage and Part D (prescription drug) advertising, phone calls and mailings trumpeting the onset of the annual open enrollment period.

Overlooked in all of this is the fact that, for South Carolina Medicare Supplement plans, there is no certain open enrollment period. You can change Medicare supplement plans at any time, as long as you can qualify medically.

However, Medicare Advantage plans and Part D prescription drug coverage plans, do have an annual enrollment period, which runs from Nov 15-Dec. 31 of each calendar year. Then, Medicare Advantage plans have an additional enrollment period (with some stipulations) from Jan. 1-Mar. 31.

If you have a Medicare Supplement, though, don’t be confused. The best time to re-evaluate your coverage and save money is during the middle of the year when no one else is doing it!

South Carolina Medicare Plans

South Carolina Medicare Plans fall into two categories. The first category is South Carolina Medicare Advantage plans; the second is South Carolina Medicare Supplements.

South Carolina Medicare Advantage plans are a privatized version of the government’s original Medicare. With these plans, the insured has coverage provided exclusively by a private company. You still pay your premium (Medicare Part B) to Medicare; however, the private companies provides your insurance. These plans have typically been more popular in urban areas, where there are more doctors that accept the plans. With these plans, the insured has a system of cost-sharing (co-pays and deductibles) in exchange for a lower monthly premium and, sometimes, networks that the insured must stay within for full coverage.

South Carolina Medicare Supplements are plans that are designed to fill in the “gaps” in Medicare. These plans are standardized by the federal government (since 1992) and must follow the Medicare Supplements chart. Plans are accepted anywhere that takes original Medicare, and generally speaking, South Carolina Medicare Supplements pay the Medicare deductibles and the 20% at the doctor and hospital not covered by Medicare. There are some plans that do not cover the Medicare Part B deductible ($135/year in 2009); however, all of the plans, A-J, except one (Plan A), cover the larger Part A deductible ($1,068/year in 2009).

Questions about what the plans do and do not cover can be answered at: South Carolina Medicare Supplements or at Contact Secure Medicare Solutions.

South Carolina Medigap Plans Eliminate the Uncertainty in Senior Health Insurance

South Carolina Medigap plans are an important part of any senior’s financial planning. Healthcare can be one of the largest variables in a budget, and especially in times of economic uncertainty and uncertainty with the healthcare system, South Carolina Medicare Supplements  stabilize your healthcare expenses.

Because South Carolina Medicare Supplements fill in the “gaps” in Medicare, you can be assured that your out-of-pocket healthcare costs are extremely minimal (or, in many cases, completely eliminated). Peace of mind like that is hard to find in this ever-changing financial climate.

The Secure Medicare Solutions web site offers free quotes: South Carolina Medicare Insurance Supplement Quotes.

South Carolina Medicare Supplement rate changes

Just like many other things in this time of economic downturn, some South Carolina Medicare Supplements are undergoing rate increases/changes during 2009.

With that said, it is more important than ever to have a South Carolina Medicare Insurance quote done to ensure that you are paying no more than you should for your South Carolina Medicare Supplement.

Since South Carolina Medicare Supplements are standardized, plans are the same from company to company. So, the primary factor in choosing a plan should be price and reputation of the company. That makes keeping an eye on your rates (and the rates of other South Carolina Medicare Supplement companies) essential.

You can view the South Carolina Medicare Supplement standardized chart at the following link: South Carolina Medicare Supplements Insurance and Plans.

You can have an updated South Carolina Medicare Supplement rate quote comparison emailed to you: South Carolina Medicare Insurance Supplement Quotes.

Upcoming Medicare Advantage Changes

As you have probably heard, Medicare Advantage plans also are in for many changes in the upcoming year(s). While it remains to be seen exactly how far the changes will go, some of the changes have already had significant effects.

 

First of all, changes are coming in the Private Fee for Service (PFFS) plans. Tighter regulations and lower doctor reimbursements for these plans have led to three major players in the PFFS plans to announce they are dropping their PFFS contracts for 2010 (WellCare, HealthNet and Coventry). These companies will still be active in other aspects of Medicare Insurance, but the dropping of the PFFS plans from these three companies affects approximately 500,000 insured individuals.

 

As always, SMS will keep you informed of additional MA changes as they are announced. It is anticipated that other companies will also make changes in the PFFS marketplace. If you have a Medicare Supplement, this does not affect you directly; however, most agree that those with Medicare Advantage plans should be prepared to re-evaluate their options during this year’s annual open enrollment period (Nov-Dec).

The 2010 Medigap Changes

Medicare announced in March of this year changes to the standardized South Carolina Medicare Supplements that will take effect June 1, 2010. If you already have a Medicare Supplement, this will NOT affect any current coverage that you have.

 

The only people that will be affected are people who turn 65 on or after 6/1/10 or those who switch plans/companies after that date. Some major changes are:

 

  • Preventive Care and At Home Recovery are deleted from all plans that included them.
  • Medicare Hospice coverage is added as a basic “core” benefit to all plans.
  • For Plan ‘G’, At Home Recovery is gone, but the Part B Excess charges amount goes from 80% to 100%.
  • Plans ‘E’, ‘H’, ‘I’ and ‘J’ are eliminated.

In the coming months, we will be publishing more information on our blog about additional changes associated with the 2010 revamping of the standard Medigap plans.

 

For specific questions about the plans, you can contact Secure Medicare Solutions toll-free at 877.506.3378 or contact us online: Contact Secure Medicare Solutions.

North Carolina Medicare Supplements

While we are headquartered in South Carolina, we also are licensed in and specialize in North Carolina Medicare Supplement plans. Medicare Supplement plans are standardized federally, so the North Carolina Medicare Supplement plans are the same as the South Carolina Medicare Supplement plans.

Recently, several well-known and reliable companies have come out with new and improved rates in North Carolina. You can find information and affordable North Carolina Medicare Supplement rates by contacting us on our web site or toll-free at 877.506.3378.

The Secure Medicare Solutions E-Newsletter

We have a new way to communicate the latest in news and updates about the ever-changing world of Medicare and Medicare insurance… an e-newsletter.

This e-newsletter will come out periodically and will contain updates about the world of Medicare and Medicare insurance. Things are changing rapidly… don’t get left behind!

You can sign up for the Secure Medicare Solutions E-Newsletter by visiting the following link: SMS E-Newsletter Mailing List.