June 2015 | Omaha Insurance Solutions

A popular show on AMC is Turn. It is about General Washington’s spies during the Revolutionary War. You find out quickly that intelligence is critical for an army to be successful. It was intelligence that moved Washington to cross the Delaware River Christmas night to catch the Hessians sleeping at Trenton. That victory was one of the turning points in the war.

Do you have the best Intel on your Medicare supplement? Part-time supplement sales people know very little about Medicare, Medicare products, and the insurance industry. How could they? They have little training. They do it when they are not doing their day job or taking care of family concerns. The insurance companies and agencies that recruit them do not invest a great deal of money or energy in them because they know most of them will not be there next year. Consequently, their knowledge is very shallow.

Why’s that important? Because they are making recommendations for you about your Medicare supplement. They do not have the training, tools, or experience to pull back the skin on these insurance products to see all the moving parts.

For example, what was the annual rate of increase for a Medicare supplement for the past five years? If client premiums increased 2% or 12%, that is a big difference and big deal. Yes, prices go up, but will the insurance company give you a great price today and turn around 3 years later to jack them up? As we age, the chance of health issues arising is much higher. It will be more difficult to change companies when we get older. You don’t want to be stuck with a company that is going to drive the prices through the roof as you age.

9435575-Graph-paper-with-profit-loss-chart-Stock-Vector-graph-arrowWhat is the age increase? Each year most supplements will go up as you age because the costs go up as we age. Is the age increase 2% per year 4%, 7%. That’s important. Does the company have a real low price when you turn 65 or 66, but then goes through the roof by the time you are 80?

An experienced insurance profession will be able to show you the numbers, interpret the numbers, and explain the numbers.  The cheapest price is not always the cheapest price.  There are other variables.  That is Medicare Intelligence.

Intel is important for armies to win battles. It is important for people selecting Medicare Supplements so that there are no costly ambushes down the road.  Medicare Intelligence shows the hidden flaws.

The Affordable Care Act (ACA) has brought many questions to business owners and individuals alike. What plan is the best? What kind of healthcare will you qualify for? Will you get to keep your same doctors? For those who are retired or close to retirement, the subject can be even more complicated. When you retire or turn 65, do you have to enroll in a Medicare Plan?

Essentially, yes. Joe Baker, president of the Medicare Rights Center, a national, nonprofit advocacy organization, warns that if you don’t enroll in Medicare at the age of 65, “you don’t have primary coverage, which means that you basically don’t have coverage for most of your healthcare needs.”

Many individuals are confused by this, perhaps rightfully so. The fact is, although your health insurance plan bought through an ACA marketplace will not automatically end when you turn 65, its coverage decreases dramatically. The message that Baker and other Medicare professionals are trying to get out to the public is that these individuals who are currently covered by the ACA before turning 65 must enroll in Medicare once they reach that age.

Now, it is important to realize that if you’re 65 or older and are covered by large-employer insurance, this rule doesn’t apply to you; however most people in this situation should at least take Part A, which is hospital insurance. Without this exception however, new Medicare enrollees must apply at least four months after they turn 65, otherwise they’ll have to wait until the next open-enrollment period, with no coverage in the meantime.

Timing is also important when switching from the ACA Marketplace to Medicare coverage; with individuals being warned to take care when they discontinue their exchange coverage as to not leave a gap between that coverage and Medicare enrollment.

The licensed insurance agents at Omaha Insurance Solutions are here to answer any of your questions you may have about Original Medicare, an Omaha Medicare Advantage Plan, and any other Medicare concerns you may have. Please contact us today at (855) 367-3631.

You can also find more information at Medicare.gov.

 

When I was 23, I fell down a mountain while jobbing in Mexico. It was my 2nd trip. My tumble resulted in some serious scrapes and cuts. The nurse at the school I was studying strongly suggested that I get a tetanus shot since I couldn’t remember the last time I had had one. I found a doctor who under stood a little English and I supplied the rest in Spanish. I think he injected me with the right stuff because I didn’t die or turn green. I paid him $10 US dollars. I was no worse for the wear. It is easy to bounce back when you are 23.

I’m currently 53. I don’t think I would have bounced back as readily now, but I also probably would not been running up a mountain. Accidents, however, do happen. They happen at home, and they happen abroad. A common question I get from baby boomers who travel is: ‘what will Medicare cover abroad?’ The answer is fairly simple. Nothing. Now let me offer some nuance.

Medicare and Foreign Travel

Original Medicare will cover you if you find an American hospital in a foreign country. Not very likely. You could claim Medicare when you are on a cruise if you are within 6 hours of the mainland. Original Medicare is not your solution for medical coverage in a foreign land.
Medicare Advantage may cover you for emergency and urgency care needs worldwide with some plans. You need to check your specific Medicare Advantage plan. Check under emergency and urgent care.
Medicare supplements or Medigap plans offer some minimal coverage. You generally have a $250 deductible. They will pay 80% of the medical cost up to a $50,000 LIFETIME limit. Of course, any serious accident, heart attack, stroke etc. will eat into that amount very quickly. Check the specifics of your plan.
So what is the solution? One of two things. Cash. Don’t leave home without it, and travel insurance. You can purchase travel insurance for the duration of your trip to cover anything devastating at a reasonable rate.
Vacation is about fun, so plan.  Planning for the worst will insure that you have the best time during your time in the sun.

Sheep get sheared.  They follow the other sheep into the pen, down the shoot, then in to the hands of the shearer and are fleeced.  The ram is a alert.  He doesn’t go with the flow he leads the way and butts heads when he is force to go where he doesn’t want to go.

How do people pick their Medicare supplement plan and company?  They talk with their buddy on the left and their buddy on the right.  ‘They both can’t be wrong.’  Everyone says Plan F is “the best.”  “I never have to pay anything”—no co-pays.  That’s great!  Sign me up.  That is the thought process of the sheep.  Insurance companies love it.  Insurance agents love it.  Plan F is the most expensive plan in all kinds of way.

Plan F

Plan F

There are ten possible Medicare supplement plan types that an insurance may offer–A–N.  In reality, they usually only offer 4 or 5.  Plan F is the most popular as well as the most expensive.  Insurance companies and agents like that because it brings in the most money and pays the highest commission.  But is it the best for a client?

Plan F does cover all the deductibles and co-insurance that Medicare doesn’t cover.  That is nice, but you pay a price for that convenience.  It raises the question whether Plan F is the best.

Is there an alternative?  How about Plan G?  Plan G is very close to Plan F.  The difference is that you pay the Part B deductible of $147.  It is a one-time annual deductible.  Once you pay your Part B deductible of $147, for let’s say a doctor’s visit, you are done for the year.  Everything else will be covered 100% which is similar to a Plan F.  So why plan G?  Because the premium is lower—quite a bit.

Plan G

Plan G

Let’s do some simple math.  Let’s say that a plan F is $150 per month for a 65 year old male and a plan G is $110 for the same person.  The difference is $40 per month and $480 per year less for the Plan G.  Subtract the $147 Part B deductible, and you are still ahead $333.  Putting it another way, you are paying $333 for the convenience of having the insurance company pay your Part B deductible so that you don’t have to write a check IF you go to the doctor or have some other procedure.  Multiply that times 10 years and you are at $3,330.

The second and more important consideration about Plan G is that the rate increases are smaller and less frequent.  Yes premiums go up because medical costs go up, but the unusual reality about Plan G policy holders is that they generally do not go to the doctor or emergency room as frequently as Plan F policy holders.  There is something about the $147 deductible that causes people to pause and think.  ‘Is this really medically necessary?’  The result is that, because Plan G policy holders do not over use medical benefits to the extent Plan F policy holders do, the claims and cost are not has high.  Consequently the rate increases for Plan G’s are fewer and smaller than Plan F.  Plan F is the best?

Don’t be a sheep.  Don’t follow the herd.  Stop and look at the different plans.  Ask yourself the hard question in light of the facts whether Plan F is the best.  Do some analysis, and you will save money in the short, long, and longer run.

ChrisGrimmond402-614-3389; Chris@OmahaInsuranceSolutions.com

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Chris has been our insurance agent for five years. He made the whole Medicare process easy to understand and paid attention to every detail to tailor a program that would be a best fit for us. If we have a question or issue, Chris responds back immediately! He’s been an absolute pleasure to work with! We highly recommend Chris for all your Medicare and Insurance needs.

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