AEP, ObamaCare & Medicare Supplements

One of the most common questions we're being asked lately is, “Will my Medicare Supplement change this year?”  Generally people have one of two reasons for asking this question.  There are those concerned about the Annual Enrollment Period (AEP) affects them, and there are those concerned about the Affordable Care Act (ObamaCare) affects them.  The answer to the question, regardless of your concern, is “No.”

The Annual Enrollment Period is an enrollment period that applies to Prescription Drug Plans (PDPs) and Medicare Advantage Plans (MAs), but it does not pertain to Medicare Supplements whatsoever.  Both Prescription Drug Plans and Medicare Advantage Plans are set up on one-year contracts with the government to offer Medicare services.  Thus, during the Annual Enrollment Period, these plans announce their changes for the upcoming year and give you a chance to change your plan if you like.  However, a Medicare Supplement does not hold an annual contract with the government, and thus it does not have to renew anything at the end of the year.  Your coverage simply continues on without requiring you to take any action.  This is one of the reasons a Medicare Supplement remains one of the most stable, dependable, and comprehensive coverages available.

ObamaCare, similarly, does not affect your Medicare Supplement either.  In fact, ObamaCare really doesn’t even effect Medicare that much.  There were a few changes that went into effect back in 2010, but there is nothing new that will roll out in 2014.  The ObamaCare deadlines you keep hearing about are only applicable to individuals who do not receive Medicare benefits.

So there you have it.  If you have a Medicare Supplement, sit back, relax, and enjoy your holidays! 

* If, on the other hand, you have a Medicare Advantage Plan and/or a Prescription Drug Plan and you are dissatisfied with the changes your plan is making next year, please give us a call or drop us an email and we’ll help you sort through your options.  We have access to nearly every Medicare and prescription plan available in Idaho and we’d love to help take the complexity out of your search.

Scam Alert

Every so often we get emails regarding the latest Medicare-related scam circulating our the Idaho, Oregon, Washington, Utah, and Montana region.  The most recent one involves diabetic supplies.  In short, Medicare beneficiaries are getting calls from a diabetic supplier who is informing them that as of July 1, 2013, many suppliers of diabetic supplies are going out of business.  This company, however, is not going out of business and will gladly offer to be your new supplier.  Although this scam pales in comparison to many of the other ones we see, it did prompt us to write this article.  While tips to avoid every insurance scam ever imagined would fill volumes of books, we’ve boiled it down to five general rules that will get you past most any scam.

1. Make sure you know who your coverage is through.  We recommend writing the names of your insurance companies down on a piece of paper and sticking them on your refrigerator or somewhere you see often.  If you have a Medicare Supplement (e.g. Bankers Fidelity, Mutual of Omaha, or Continental Life), your Prescription Drug Plan is mostly likely with another carrier (e.g. Humana, First Health Part D, AARP United Healthcare).  If you have a Medicare Advantage Plan (e.g. True Blue, Pacific Source, Regence MedAdvantage) your health and your prescription coverage will likely be combined into one policy.
2. Don’t respond to anything.  If you receive anything (letter, post card, flyer, etc.) that looks like it’s from Medicare or your insurance company, DO NOT respond using the information provided.  Instead, call Medicare directly (800-633-4227) or your insurance carrier, depending on who the scammer is trying to impersonate. 
3. Don’t give out personal information.  If you get a phone call from Medicare or your insurance carrier, and they begin asking you personal information, hang up.  If you’re afraid that it may have been a legitimate call, simply place a call to Medicare or your carrier telling them that you received a call from them and wanted to see if there is anything they need.  Most carriers will NEVER ask for personal information over the phone.
4. Look for promises and pressure.  One common tactic of scammers is, ironically, to appeal to our fear of getting ripped off.  If there is some deal with loads of promises that sounds too good to be true, it probably is.  While there have been several changes to Medicare in the last few years, there is nothing new that is going to take away all your problems.  Also, be wary of anything or anyone that is trying to get you to act RIGHT NOW!  Any deal that is going to expire soon (like before they get off the phone) is not legitimate.
5. Use us.  If you ever get a call or receive something in the mail that sounds or looks fishy, don’t ever hesitate to drop us a call (800-817-9223) or email.  Often in just a few minutes, we can help you discern whether you’re in a situation that actually requires something from you, or whether you’re holding a 8½ x 11 inch waste of time.

The above relates specifically to insurance; below are some helpful links to avoid other types of scams. 

Idaho Attorney General

FBI Fraud Schemes

What about hearing aids?

Every so often we get questions about hearing aids.  Does Medicare cover them?  If not, will my insurance cover them?  If not, can I buy stand-alone hearing insurance?  And not surprising either, since hearing aid costs can range up to $10,000 for a set.  So what’s the scoop?

First, Medicare does not cover hearing aids.  Medicare will cover hearing and balance tests when ordered to treat you for a medical condition, but not to determine a need for hearing aids.  Since Medicare Supplements are bound by law to only fill in the gaps within Medicare (and not provide extra coverage), they are unable to pay for hearing aids.  Some people choose to receive their Medicare benefits via a Medicare Advantage Plan rather than through Original Medicare hoping to receive extra benefits.  However, most Medicare Advantage Plans in Idaho do not include hearing benefits either, and those that do typically only cover one hearing exam per year, and offer no coverage for hearing aids. 

However, all hope is not lost!  There is the option to purchase a stand-alone hearing insurance coverage.  While these policies aren’t just falling off trees, we do have one option in Idaho.  It is a combination Dental-Hearing-Vision policy and offers up to $2,000 per year in benefits.  The best part about this coverage is that it allows you to see any dentists, optometrist, or audiologist you wish, unlike many plans that restrict you to a network of providers.  This can prove to be a huge advantage in that it allows you to shop all kinds of retailers, including large discount chains like Costco where prices can be half of those found at hearing aid specialty stores.  If you would like more information about this coverage, please call or email us anytime at:  800-817-9223 or info@tweedyinsurancegroup.com.

Common Insurance Terms

Ha, you think!  The only thing common about insurance terminology is that they're all confusing.  We understand.  After all, insurance terminology is the second cousin to legalese!  Trying to read through a Summary of Benefits, or other health insurance material can be an exercise in frustration if you don't know the lingo.  That's why we've put together the following guide: Insurance Terminology in Plain English. 

Because we love simplicity, this isn't an all-inclusive guide of every insurance word ever used.  But, it will hit many of the most commonly used terms.  If you'd like to dig a little deeper, check out the two links below.

• A Glossary of Medicare Terms (c) Medicare Interactive
• Medicare.gov/Glossary

Plan G Looks Even Better

Since 1991, the Plan F has dominated the Medicare Supplement market.  It is easy to understand why; Plan F pays 100% of everything that Medicare approves.  However, in the last few years, Plan G has been quietly gaining popularity among consumers.  The difference between the two?  Plan G does not pay the Medicare Part B deductible while Plan F does.  So, how much is the Medicare Part B deductible you may ask.  In 2011 it was $162.  By taking on this additional liability, insurance companies are willing to drop the premium - sometimes as much as $25 per month.  Doing the math it is easy to see that you can save money in the long term with a Plan G.

• $25 monthly savings x 12 months = $300 annual premium savings
• $300 annual premium savings - $162 annual deductible = $138 net annual savings

Over the last few years the Medicare Part B deductible has risen each year.  Consequently it came as a surprise to see that in 2012 the deductible was reduced to $140.  Whatever the reasoning that led to this decision, it has turned out to make Plan G an even more attractive option. 

• $25 monthly savings x 12 months = $300 annual premium savings
• $300 annual premium savings - $140 annual deductible = $160 net annual savings

While we're not quite sure yet how this helps to keep Medicare solvent, we'll continue to take it one change at a time and make the best decision we can with the rules we have.  And with this change, Plan G looks better than ever.

2012 Medicare Deductibles Released

Medicare has recently released the 2012 Medicare deductibles, copays, and coinsurance rates.  If you are covered by Original Medicare and do not have a Medicare Supplement, these are the cost-sharing figures you can expect to pay in 2012.  If you have a Medicare Supplement, your coverage may most or all of these costs on your behalf.

Click here to see the 2012 amounts.