Here are the Medicare changes for 2012:
| 2011 | 2012 | |
| Part A (hospital) Deductible | $1,132 | $1,156 |
| Hospital Copay (days 61-90) | $283 | $289 |
| Hospital Copay (days 91-150) | $566 | $578 |
| Skilled Nursing Facility coinsurance (days 21-100) | $141.50 | $144.50 |
| Medicare Part B Monthly Premium* | $115.40 | $99.90 |
| Annual Part B Deductible | $162 | $140 |
*for those not affected by the Part B income-related monthly adjustment
I had a long conversation with a rep from a local newspaper today. The subscription rate went up substantially, which didn’t make me very happy. The paper’s customer service person immediately started negotiating the subscription price down to something I would accept. While I like getting a good deal, the whole conversation was frustrating. Haggling over the price of a car is one thing, but a newspaper? Shouldn’t the price be the price with no negotiation necessary?
What about Medicare Supplements? Can you negotiate a better rate than your neighbor? Is buying a policy directly from an insurance company less expensive than purchasing through an agent? Do some agents get better prices from insurance companies than other agents?
The answer to all of the above questions is a resounding “NO”. Medicare Supplements are very regulated insurance products. Before a company is allowed to sell a Medicare Supplement in Illinois or raise their rates, all prices must be approved by the state Department of Insurance. With Medicare Supplements, the price is the price. Whether you purchase your Medigap policy direct with a company or through any agent licensed to sell in Illinois, the price will be the same.
Yes, you can! However, that’s not the only time of year when you can change your Medigap coverage. Medicare’s Annual Open Enrollment period applies to Medicare Advantage plans and Medicare Part D prescription drug plans, not Medicare Supplements.
In 2011, between October 15 and December 7 anyone with a Medicare Advantage plan or a Medicare Part D plan is encouraged to explore his/her options for 2012. For most people, this is the only time of year to make these changes. Once the Open Enrollment is over, you will be locked in to your plan choices for all of 2012 (with a few exceptions).
Medicare Supplements are different. There is no lock-in for Medigap/Medicare Supplement policies. You are free to switch your Medicare Supplement coverage or company any time during the year. Most insurance companies will ask some health questions to determine whether or not they will sell you a new Medicare Supplement policy. These health questions and the underwriting criteria vary from company to company, so it’s a good idea to contact an independent agent who can recommend a company that would be most likely to accept you.
If it’s been more than a year since you looked at your Medicare Supplement options, now is a good time to give Benefit Consultants – Midwest a call at 877-312-1414. We can compare your rate and coverage with all the major companies in Illinois to be sure you are making the best investment of your premium dollar.
This is important for every Medicare enrollee and his or her family to know. An Advance Beneficiary Notice or ABN is a waiver that medical providers are required to have you sign before they give you treatment that they have reason to believe Medicare will not cover because Medicare will likely determine the treatment is not medically necessary for you.
You will not receive an ABN for services and supplies Medicare never covers, such as hearing aids. You also won’t receive an ABN if you are in a Medicare Advantage plan (HMO, PPO, POS, PFFS). In that case, coverage determinations are made by the MA plan, not by Medicare.
Here is why the ABN is so important. If you are not given an ABN to sign before your provider gives you a treatment or medical item, the treatment or item is not explicitly excluded from coverage by Medicare, and Medicare chooses not to pay, you do not have to pay for the service, treatment, or medical item.
If you do sign an ABN before the service, treatment, or medical item is received, and Medicare chooses to not cover it, you will have to pay the medical provider.
If you do sign an ABN for treatment that you and your doctor believe is medically necessary make sure the claim is submitted to Medicare. There is a chance that Medicare may cover the charge and there is the option to appeal initial coverage decisions by Medicare.
This link will take you to the CMS ABN instructions and form for informational purposes.
Can I buy life insurance if I’m over 65?
As all of our stock portfolios and home values keep taking a pounding in this economy, we’ve been hearing this more and more from our clients. The short answer is a qualified “yes”.
If you are worried about leaving debt behind for your heirs or if the nest egg you expected to be your legacy has shrunk in recent years, life insurance may be a solution to your needs.
A woman, age 70, living in Illinois can purchase a $100,000 term policy for about $75 per month, guaranteed for 15 years. A 70 year old man in Illinois can purchase $100,000 of term life coverage for $124 per month, guaranteed for 15 years.
Of course the above are sample rates. Buying life insurance when you are over age 65 is very similar to purchasing life insurance for those under age 65, but you may be subject to more underwriting requirements. Typically, an insurance company will require you to answer health questions, submit a statement from your physician, undergo blood work, an EKG, urinalysis, and a paramed exam. Much of this can be taken care of in your home, and your agent will be available to answer your questions and address your concerns through the process.
If you are thinking about adding financial protection to your estate through life insurance, give us a call today at 708-804-0300. We’d be happy to discuss your options and give you quotes personalized to your situation.
The short answer is that there is no “best” one-size-fits-all Medigap or Medicare Supplement policy in Illinois. The best one for you may be completely different from the best one for your neighbor or even your spouse.
A good place to start the search for a policy is here. Medicare Supplement coverage is standardized, so no matter which insurance company you choose for purchasing your Medigap policy, the coverage for a plan F, G, N, or any other available lettered plan will be identical to the same lettered plan sold by any other company in Illinois. It’s important to note that even though the coverage is the same from company to company, the prices can and do vary widely.
The most common Medicare Supplement policies sold are Medicare Supplement Plans G and F. As you can see from the chart, these provide the most comprehensive coverage, but they are also the most expensive. Medigap Plan N is a new Medicare Supplement that was released in June of 2010. This plan is already gaining immense popularity due to its fairly comprehensive coverage and low premiums. Medicare Supplement Plan N does have office copays for outpatient office visits and emergency room visits, but if you are in good health and make fewer than six office visits per year, the premium savings of a Plan N versus a Plan F or G is certainly worth a look!
Once you have decided which Medicare Supplement plan best fits your needs, it’s time to find and compare the companies that sell that Medigap plan in your area. As of this writing, there are 44 different companies offering Medicare Supplements in Illinois. Not all of those companies sell all of the Medigap lettered plans. Each insurance company must offer Medicare Supplement Plan A, but they are free to choose which of the other Medigap plans they would like to sell. The state of Illinois provides a publication listing all insurers and which Medicare Supplement plans they offer, but it tends to be a bit out of date.
So, which of those many companies offering the Medicare Supplement policy that you want is the right fit for you?
That depends on your situation. If you are just enrolling in Medicare Part B, you have more options and can shop around for the best price. If you are replacing your current Medicare Supplement policy, you should look at each company’s underwriting standards to see which company will accept you for the most reasonable premium. And, whatever your situation, it’s important to research the insurance companies’ history of rate increases to know before applying how often and how much you can expect rates to rise.
If you think that sounds like a lot of work, you’re right! So, if you’d rather not go it alone, why not give our free service a try? We do all the research listed above plus keep you updated when rates change after you have your policy, and we do it all at no charge to our clients. The insurance companies can’t charge you more for obtaining a policy through a broker, so there is really no benefit to wading through all the information on different plans and companies by yourself. Give us a call at 708-804-0300 and speak immediately to a real person who has experience and insight into the Medicare Supplement market.
Now that the AEP (Annual Enrollment Period) has come to an end, the next season in the alphabet soup Medicare calendar is upon us. The MADP (Medicare Advantage Disenrollment Period) began on January 1 and ends February 14. The first question to answer is: What is the MADP?
Those enrolled in a Medicare Advantage plan may choose to disenroll from their current MA or MAPD plan and return to Original Medicare between January 1 and February 14. Anyone who chooses to disenroll from their plan will have a Special Election Period (SEP) in which to enroll in a Part D prescription drug program to supplement Original Medicare.
Am I allowed to join a different Medicare Advantage plan?
No. During the MADP, your only option is to stay in your current plan or disenroll and return to Original Medicare.
If you are considering disenrolling from your current Medicare Advantage plan or if your plan is experiencing a Service Area Reduction which will affect your care, now is a good time to take a look at Medicare Supplement or Medigap coverage to help with all of the expenses not covered by Original Medicare. At Benefit Consultants – Midwest, we are Medicare Supplement experts in the state of Illinois and would be happy to help you compare your options! Contact us today!
Recently, we’ve had a lot of phone calls from folks who are confused by the Medicare Open Enrollment ads airing on tv and radio. The confusion is understandable! An actor or actress says that this is a time to “change your Medicare” but doesn’t explain what that means. Below is a sampling of the questions we’ve gotten with answers. Hope this helps!
1. If I’m turning 65 in 2011 do I have to make a Medicare decision by December 31, 2010?
No. Everyone turning 65 has an initial Medicare enrollment period that begins 3 months before their birth month and ends 3 months after their birth month. The initial enrollment period applies to Medicare Part B, Medicare Advantage Plans, and Medicare Part D prescription drug plans. Medicare Supplements work a bit differently. The Medicare Supplement Open Enrollment Period begins in the month that a person is BOTH 65 or older AND enrolled in Medicare Part B and lasts for six months.
2. Can I change my Medicare Supplement without answering health questions between November 15 and December 31?
Generally, no. The Open Enrollment Period from November 15 through December 31 applies to Medicare Advantage Plans (Medicare Part C) and Medicare Part D prescription drug plans only.
(If you are turning 65, enrolling in Medicare Part B, or have a Medicare Supplement/Medigap guaranteed issue event between November 15 and December 31, you would be able to purchase a Medicare Supplement/Medigap policy without answering health questions, but that would have nothing to do with the Open Enrollment Period.)
3. Will the Medicare Part D prescription drug plans raise their prices for 2011 after Open Enrollment ends?
No. Each Medicare Part D plan is approved for sale by Medicare and is not allowed to alter plan design or pricing after approval. The only likely exception would be if a drug is taken off the market for safety concerns.
4. Where can I go to find which Medicare Part D prescription plan is right for me for 2011?
The best place is your local pharmacy. If you have a trusted pharmacist, he or she is able to compare all plans available in your area to find one that covers all your medications with the least possible amount of restrictions and at the lowest price. Another option is the Medicare website, www.medicare.gov. The health and drug plan finder allows you to enter your zip code and current medications to customize a list of all plans in your area and their coverage and cost based on your drugs.
5. So, when can I switch my Medicare Supplement/Medigap policy?
Anytime! If you are not in the Medigap Open Enrollment or a guaranteed issue situation, you may have to answer some health questions, but you are free to purchase a new Medicare Supplement whenever you like. If your rates have gotten too high, or if you’d like a different level of coverage, give us a call at 708-804-0300 in Illinois. Our experienced, knowledgeable brokers will comparison shop all the companies we represent with you to find the combination of coverage and price that best fits you! To get an instant IL Medigap quote online, visit our Medicare Supplement rate calculator.
Although they were not released in time to make the new Medicare & You 2011, the 2011 copays and deductibles for Medicare Parts A & B are now available. Here they are compared to 2010 amounts:
| Deductible/Copay | 2010 | 2011 |
| Part A Hospital Deductible | $1,100 | $1,132 |
| Part A Hospital Coinsurance Days 61-90 | $275 | $283 |
| Part A Lifetime Reserve Days 91-150 | $550 | $566 |
| Skilled Nursing Facility Coinsurance Days 21-100 | $137.50 | $141.50 |
| Medicare Part B Deductible | $155 | $162 |
Most people will keep paying $96.40 for the Medicare Part B monthly premium.
New Medicare beneficiaries will have a Medicare Part B premium of $115.40 per month (this may be higher for high-income individuals).
Any questions? Contact us. We’re here to help!
Beginning November 15, Medicare Advantage and Medicare Part D enrollees have the option to switch from their current plans to other ones. As explained elsewhere on this site, Benefit Consultants – Midwest does not sell Medicare Advantage plans, so this post will only concern Medicare Part D prescription drug plans.
Unfortunately for Medicare recipients, this time of year tends to be a feeding frenzy for insurance agents specializing in the Medicare market. Phone calls and mail pieces regarding Medicare Part D deluge Medicare recipients in a flood of largely superfluous information.
Just because a “new” plan has a lower monthly premium than your current plan, that alone will not make it the best use of your premium dollar. Deductibles, copays, and drug coverage combine with the monthly premium to constitute your total expense estimate for the coming year. The one with the lowest monthly premium may not end up being the best value for you. So, how do you compare plans?
1. If you have a trusted local pharmacist, visit him or her. Most pharmacies are equipped to compare all Medicare Part D plans in your area based on your current prescription medications and can give you print-outs of the estimates from plans that will cover your prescriptions with the fewest possible restrictions and at the lowest estimated cost.
2. Do it yourself. The drug plan finder at www.medicare.gov provides a good tool to compare plans based on your zip code and prescriptions. Things to look for in a plan are:
Once you have narrowed down the list to plans that cover all your medications with the least possible number of restrictions, then you can look at the total annual estimated cost to find the plan that is estimated to be the best value for your money in 2011.
3. If you have a trusted advisor, such as a Benefit Consultants – Midwest representative, he or she can help you navigate the many Part D choices. If you are in Illinois and have any questions, please call us at 708-804-0300.
