Medicare and Indemnity Products – We Can Help With That

Understanding insurance is important. Insurance is purchased before an event happens against the risk that it might happen. Some get confused and want to get insurance coverage after the event has happened. That does not work. Let’s take a few minutes to talk about how that applies in one instance to medicare advantage and supplement programs.

Maybe you have an HMO or PPO Advantage program for the last five years and are beginning to experience more and more health issues and visits to the doctors. You are concerned that a major problem could bankrupt you and so you look into a supplement. You have heard that a supplement will cover your deductibles and copays, which are increasing.

Here is what you find. Advantage and supplement or Medigap are mutually exclusive. You don’t have both, you have one or the other. Some agent tells you that you can have both and you are confused. It can be confusing. But you cannot have both.

You also find that a supplement has premiums adjusted for age. A $120 a month supplement at 69 is now $140 a month or more.

You also find that a supplement after your first year on an advantage program requires medical underwriting. Any health issues have to be communicated and affect your ability to get that supplement versus your advantage program.

Ouch, what can you do? You are concerned that the maximum out of pocket for your program is so high you can’t pay it many years in a row. Your MOOP could be $6000 or much more.

This is one of the reasons people buy a supplement in the beginning instead of an Advantage program. The Advantage program is good if you have little medical experience, which is common at age 65. But as you age, the medical gets more and more expensive with deductibles and copays. The supplement gives you a budget amount each month and with the right plan covers those deductibles and copays. You need to review the supplement you choose. They are not all equal, though they are all the same coverage carrier to carrier when on the same plan such as G or F or N.

What can you do? There is a good alternative and I would be happy to talk with you about it. Good carriers have INDEMNITY packages designed to insure against expensive hospitalizations and short term care and emergency and even cancer. Of course they are purchased before you are diagnosed, but some have short waiting periods such as you have not been hospitalized in the last six months for an issue, even though the issue is present. There is a lot to consider, but an indemnity plan in your mid retirement years is a good option. You don’t want to wait long, because of course the rates increase as you age and you may find yourself in the middle of an issue and you needed the insurance before you arrived at that point.

Okay, these are just simple notes. INDEMNITY packages are not medicare. They are an adjunct health product to give you increased financial protection against risks. They can be good for you if you have had an Advantage product or original medicare for a while and are getting concerned about future healthcare costs.

There are alternative ways to protect yourself and your financial stability and make sure you have what you need to get the healthcare you need as you age. We can help with that.

Call 405.494.0637 or phil@soluminsurance.com. We can help with that.

Not about insurance, but all about you…..

As consultants to seniors at grandkidsmatter.org, we are hearing a disturbing problem. Pastors and Christian ministry leaders tell us they have lost connection with the largest population in the U.S. 10,000 people a day turn 65 in the US. The churches focused on millennials and now the next gen and are missing the fact that these seniors are faithful, connected, sociable, and forgotten. They will live into their 80s and 90s and the church is missing them.

This township in New Jersey has been sensitive to address these issues for 30 years. What insight they have. Does your church have a senior advisory group? Not a senior ministry, but someone or someones who have the ear of the leadership to help guide polity and ensure the Biblical design of extended and full family stays intact?

As part of our benefits for seniors in 2020, GrandParenting Seminars will include special time with church leaders to share insights and tips.

https://www.montclairlocal.news/2019/11/09/senior-citizens-30-montclair-nj/

Contact me and tell me how this trend is affecting your life..

phil@soluminsurance.com . 405.494.0637.

Phil ..

Medicare – Simple and Personal Choices

This morning in the quiet of my lake cabin, I had time to stop the wheels of pressures and phone calls and emails and just listen on the inside. When was the last time you listened to that quiet reasonable voice on the inside about your healthcare?

Approaching 65 can be a monumental change and even frightening. Employers have already been encouraging you into retirement for years. Youth is valued in the work world and you may feel a little devalued. Joints are creaking and cracking and you wonder how long they will hold up. Will you be able to enjoy those trips you have planned? And then there is healthcare. You understand the ins and outs of HMO and PPO and high deductible plans with HSAs. Now, here is this thing called Medicare. We can help with that.

One of the smoothest and easiest and quickest start pages on your journey should be this one. GrandParentBenefits.org. I linked you to the page on Medicare Advantage because I like the easy intro to medicare on that page and the fact that in a few words it mentions the necessary component parts. A and B are original medicare and can be majorly expensive if that is all you have. C is an Advantage plan and gives you extra benefits but also extra limitations. D is prescription drug and you need to make sure you have it in some form. E or Medigap / Supplements is an alternative that allows maximum choice in doctors, locations, etc and gives you a predictable monthly medical expense. Your lifestyle. Your choices. We can help with that.

There is a lot more to understand about all of this. But here is a recommendation. Use a licensed agent. Take advantage of one of our agents at grandparentbenefits.org or contact me directly at soluminsurance.com. This year, I took the time to reinstate my insurance license just to help folks making the move to medicare and more.

And of course, I have a greater cause. One is helping seniors and one is helping families. GrandParentBenefits.org is the brain child of GrandKidsMatter.org. We serve those going into and currently on Medicare, whether you have grandchildren or not, we are here. We can help with that.

A Quick Note on Why We do What We Do:

In the whirlwind of politics and culture and business, we hear many pundits crying for our attention. At GrandKidsMatter.org and Fathers.com, you can find some reasonable and researched and relatable information on everything from fathers and teen daughters to grandma raising grandchildren on her own. Help with medicare is just one of the ways we reach out to families and individuals. At SOLUMCOMMUNITY.NET, you will find passion in fixing fractured families. This is our why. Family Matters. And for that reason, we want to serve you with excellence and accuracy in making your personal lifestyle choices.

How do I decide? Medicare Advantage or Supplement or Just Basic.

Every person approaching 65 or retirement after 65 from corporate healthcare coverage has key decisions to make. Those decisions impact the rest of the retirement years. They are not irreversible, but they are impactful. So here are a few tips as you make them.

1. Look at your healthcare needs of the moment.

2. Think forward. What will you possibly need five or ten years into your retirement?

3. Consider family experience. Cancer? Heart? Lungs? Joints? What have other family members had to deal with in retirement.

4. Remember your income status is changing and will continue to change. You have Social Security, maybe a pension, an income annuity, some cash at hand, investments, or a part-time job. Think forward. Your energy and ability will possibly decrease and affect income stream.

5. Remember you expense status is changing and will continue to change. Maybe you pay off the house, but still have insurance and repairs and taxes. Cars may need replaced that you have had for a while.

6. Think about planned lifestyle. Will you be visiting family and children and grandchildren for extended periods in areas more than 30 miles outside your home? Do you have healthcare coverage that travels with you?

7. What hobbies will you continue and what ones will you pick up?

8. Have you made allowance for increased dental and vision and hearing coverage as you age and those items change faster than they did in your earlier years?

9. How much will you budget annually to cover deductibles, out patient routines, drug co-pays or co-insurance?

10. What is your gift budget? All those people for whom we care and want to take our increased available hours to bless. Will you be giving increased gifts? Notes?

11. Do you understand that your decision for advantage versus basic versus supplement is usually changeable in the first year after you make your initial decision with guaranteed coverage, but probably requires medical underwriting after that year?

These are just a few question we each should consider. A good, qualified agent will help you walk through these items versus just “selling a package”. There are many options of an HMO/PPO Advantage plan with an extra indemnity package or a Supplement with drug plan and vision/hearing/dental package or basic Medicare with an indemnity package and VHD package or, or, or… there are good options and choices available and you want to take time to think it through.

No matter the decisions you make, be in health and prosper even as our souls prospers. This is a time to enjoy the fruit of many years of life and relax knowing as much as possible is covered to allow you the maximum lifestyle you want in retirement. WE CAN HELP WITH THAT!

Call 405.494.0637 or email phil@grandparentbenefits.org.

Soluminsurance.com or grandparentbenefits.org for more info.

Is Advantage an Advantage for Me? A blogafo

Medicare Advantage can be the best solution for you as you move into your Medicare supported years. The real questions are about what is best for your health and financial welfare, right? Well, that is the question you need to answer. We can help with that.

A Part C or Advantage plan is not a supplement or Medigap. They are mutually exclusive. You cannot have both. Watch out for odd language from sales agents. Get clear information. We can help with that.

You can get reasonable cost insurance for items not covered in your Advantage plan for such items as dental, vision, hearing, cancer, short term care, copays, deductibles, etc… That does not mean they are a “Medicare Supplement”, but these are other insurance policies or indemnity plans available to you. We can help with that.

Your payments to providers on Advantage are not managed by Medicare, but is managed by an insurance company. They handle the claims and coordinate services. Yes, they are subject to Medicare rules; however, can vary significantly in extra services and coordination with copays and coinsurance.

Not all Advantage plans have prescription drug coverage. Most do and you need to know. Inspect the coverage diligently before you sign up. We can help with that.

Advantage is usually an HMO or PPO arrangement. That means you have a network of doctors in your area with which you get better rates. It also can mean you are restricted to which doctors you can use cost effectively.

Advantage plans are not free. Even if they have a $0 premium, you must continue to pay your Part B Medicare amount. Your Part A portion usually is covered because of your payments over life as you worked or your spouse worked. If you discontinue paying your Part B, you will be dropped from the Advantage plan.

New Advantage plans have been created that have PPO networks nationwide to allow for travel and extended availability of services for those living in rural networks. This is great news for many. We can help with that.

Not all Advantage plans are HMO or PPO. There are fee for services plans and special needs plans for such circumstances as ESRD and Diabetes. Take time to know your health and explore options available in your area for you and your health. We can help with that.

A supplement situation may be better for you than an Advantage plan. It all depends on your financial and health situation and your personal preferences. You have choices in Medicare. The most important time to make decisions are when you first sign up for Medicare. These decisions can affect your options for the rest of your life. You are free from medical underwriting and usually receive the best rates as you start your journey on Medicare in those first decisions. No one knows how their health will play out, but you can always make informed and educated decisions. We can help with that.

Here is the official Center for Medicare and Medicaid Services site on Advantage plans. https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans

Here is our partner site http://grandparentbenefits.org/medicare-advantage/

Yes, we can help you get the information you need and understand your options to make good decisions that fit your lifestyle and budget. Call us or email us and let’s get started assisting you. There is never a fee for our services. We can help with that.

405.494.0637 cell/text

Phil@grandparentbenefits.org

What is PDP and Why Do I Care on Medicare? A blogafo (blog with information)

PDP stands for Prescription Drug Plan. Basic Medicare does not help with prescription drugs. They have made a way for you to have good coverage through qualified partnerships with insurance carriers. You need a good prescription drug plan.

PDP is not like supplements or Medigap. And supplements do not cover prescription drugs. If you have a supplement, you need a PDP also. We can help with that.

PDP is not like Advantage; however, many Advantage plans have PDP included. You need to know if you are on an Advantage plan the amount and coverage for PDP. Every carrier can be a little different in copays, coinsurance, donut hole coverage, how they handle tiers of drugs. We can help with that.

PDP is not like vision, hearing, or dental. Some advantage plans have some extra features that include these and you need to understand that. Supplements do not have these extra features, but you can add coverage to obtain them. We can help with that.

Each PDP has a star rating provided by feedback and analysis of the CMS. It is important to know this rating for a plan in your area. We can help with that.

During the annual enrollment period you can change PDP with no concerns about medical underwriting. Now, if it is part of your Advantage plan, you would need to change the full plan. We can help with that.

All PDPs are not alike. Each has a different formulary that tells you what drugs they cover and at what price to you and to them. This is important to know if you are taking special medications or even medications normal for seniors like blood pressure meds. We can help with that.

All PDPs are not alike. Pricing is different sometimes in every zip code and can vary by age and experience of people in that area and contracts the PDP has with local providers. One nationwide plan just made significant changes that assist in low to no co-pays in certain areas. You need to understand historically how a PDP has changed pricing over time. We can help with that.

Delaying on your PDP beyond initial eligibility periods can mean two issues. One, you can incur a penalty charge that affects your insurance amount for life. Whoops. Don’t want to do that. Two, you could end up having to go through medical underwriting and struggle to get the coverage you want at the price you want. Whoops. Don’t want to do that.

Resources for More Information:

The official CMS (Center for Medicare and Medicaid Services) page on PDP is https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage. It is a good, quick cover sheet on PDP. What we have done here is help you go beyond the basic facts and answer some questions.

Our partner powered by grandkidsmatter.org have a good breakdown on PDP at http://grandparentbenefits.org/medicare-part-d/.

Okay, I hope this little blogafo (blog with information) helps you today get a step closer to a good decision that fits your needs. We can help with that.

Phil@grandparentbenefits.org

405.494.0637. Call/text

Just a great set of stories

As a loyalty partner with grandparentbenefits.org, we support family efforts. This story so touched me about the power of Grandparenting. I hope it brings hope to your heart and joy to your day and expectation for a greater United States.

https://www.romper.com/p/becoming-a-grandpa-changes-fathers-these-12-moms-stories-prove-it-19199027

Whitehouse Takes Action

Recent executive order from the president directs a protection of senior benefits through medicare. While the working out of this could take decades, it gives guidance for legislation and exhibits a heart to protect the benefits many like you have paid into over a lifetime. You deserve the best. You earned it. Take time to read a few links and opinions on the potential impacts.

Let us help you find your way through the confusion of medicare and get the right options to your lifestyle.

https://www.whitehouse.gov/briefings-statements/president-donald-j-trumps-healthcare-agenda-puts-seniors-american-patients-first/

https://www.npr.org/sections/health-shots/2019/10/03/766816709/targeting-medicare-for-all-proposals-trump-lays-out-his-vision-for-medicare