Greetings:
Open Enrollment to begin soon:
Starting this year, the Medicare Fall Open Enrollment period beginson October 15th and lasts through December 7. (This is a change from previous years, when the enrollment period began in November and ended December 31.) During fall open enrollment, people with Medicare have the right to change their Medicare health and drug coverage options without restriction. They can make as many changes as they need and the last change they make on or before December 7th will take effect on January 1, 2012.
Changes in 2012
• Just as in 2011, there will be a 50 percent discount for brand-name drugs during the coverage gap (also known as the doughnut hole). The discount for generics during the doughnut hole will increase to 14 percent.
If you are in a Medicare Advantage plan, I strongly recommend thatyou consider moving back to Original Medicare due to continuing and confusing rule changes. Medicare Advantage rule changes are creating a nightmare for all of us. I will no longer recommend a Medicare Advantage plan for these reasons and also because Mayo Clinic no longer accepts these plans. Why limit your option to go to Mayo’s if you are a Medicare beneficiary and you develop a serious medical condition.
If you are looking for a way to save premium, I can put you in a high deductible Supplement Plan and achieve the same objective as Medicare Advantage and significantly reduce the confusion and risk associated with Advantage plans. Here’s the difference between Medicare Advantage plans and Traditional (Original) Medicare.
Original Medicare has One plan accepted by almost all Medical Providers!
Medicare Advantage has many different plans accepted by fewer and fewer Providers!
There’s a move in the private medical insurance sector to encourage more participation in Advantage plans, but with multiple choice plan offerings comes more confusion, rules to remember, provider contact requirements for the member to see if the plan is accepted etc etc.. and the possibility of being stuck in an Advantage plan without the option to return to Original Medicare if one’s health changes. Currently 80% of Medicare beneficiaries are in Original Medicare and 20% in Advantage plans. If you have a Medicare supplement plan, you are in Original Medicare and don’t need to worry.
New Rules for Advantage Plans:
• Medicare Advantage plans now are rated with a five star rating(on a scale of 1 to 5)
• Different plans have different networks of providers and pharmacies, so consumers who choose to enroll in a five star plan may have to choose a new doctor or pharmacy.
• Medicare Advantage Plans are now rated so the consumer must do diligent research by going to www.medicaregov/find-a-plan . A mistake in choosing could be costly because if a consumer enrolls in a Five Star Medicare Advantage plan only without prescription coverage, he or she would typically not be able to join a separate prescription drug plan until the next Fall Open enrollment period, and would therefore be without drug coverage until the following year. For these reasons, consumers should think very carefully before enrolling in a five star plan outside of Fall open enrollment.
Reading the new Medicare Advantage rules gave me a headache and I deal with this stuff every day. Why would Medicare beneficiaries need more confusion in their lives? That’s why I am removing all Medicare Advantage Options from my Tool Box of offerings for all my clients. I have just a few clients on Advantage plans and I’ll work with each of you to make sure that your plan will work for you during 2012.
The Medicare Coach Program:
Those of you who are in the Medicare Coach renewal program willreceive your billing statements during early October. A renewal member pays $50 each for a Couples membership, and a single membership is $60. This allows a review of your existing Part D (Prescription plan) for 2012. You will receive a Prescription summary form along with your billing statement, so please return the updated prescription information to us along with your payment.
We will analyze your existing plan and contact you with anyrecommended changes. The majority of appointments will be handled via phone conference and we’ll reserve face to face appointments for those who might require more in-depth planning including changing your Supplement plan to a high deductible.
Brand new members in the Coach program pay a fee of $160 to join, and then are offered a renewal membership plan with an annual October billing. If you do not participate in the renewal program at $50 or $60 per year with unlimited access to our service, and then decide to seek advice a year or two later, you’ll need to pay the $160 fee once again to rejoin. I strongly advise those of you who receive the renewal membership offer, to keep your membership current so you don’t fall in the gap and have to start all over in the program because you laid out for a few years.
Note: Medicare is a moving target with annual updates and rule changes. Even if you are happy with your current coverage, you should review all of your options on an annual basis, including Original Medicare, Supplement insurance, prescription insurance and especially Medicare Advantage if you are in this plan.
Why A High Deductible Medicare Supplement Plan Makes Sense(especially now since Medicare is under the microscope of the “Deficit Reduction Super Committee”)
If you are in good health, and continue to notice that yourSupplement plan premium is increasing by about 12% per year, and, you are paying a $150+ per month premium, then I recommend that you talk to me about switching to a high deductible plan. The majority of our clients have attained age Supplement plans which means premiums increase every year due to age , use, and costs in your medical provider area rated by zip code.
I may be able to save you about $1400 per year in premium and show you a strategy on how to turn a $2000 deductible into a $600 deductible with no major out of pocket risk on your part and still have the catastrophic coverage like you now have under your existing Supplement plan. If you go for routine doctor visits (4-5 times per year), you could have a net savings of as much as $1000 because you’ll only spend about $400 in doctor co-pays for routine visits. Then, repeat the process of saving the premium instead of giving it to an insurance company.
I have one client who has followed my strategy and now has $10,000 in her savings account. For her, a $2000 deductible is no big deal because she has recaptured it in premium savings and has moved her plan to a zero $ deductible strategy, and is in control of her premium dollars now. Whether you know it or not, the future of Medicare will move in the direction of the high deductible concept during the next 3 years. Here’s why!
The Joint Selection Committee on Deficit Reduction, also known asthe “super-committee”, held its first meeting yesterday with a goal of reaching compromise that will reduce the deficit by $1.2 trillion dollars and that Congress will approve through a fast-tracked process. If the committee and Congress do not approve a package that includes at least $1.2 trillion in savings, automatic spending cuts will take effect. Medicaid and Social Security are not subject to automatic cuts, and automatic cuts to Medicare are limited to a 2 percent reduction in payments to providers and private plans. But in yesterday’s meeting, the committee indicated that it may recommend changes to all programs-including Medicaid-Social Security- and Medicare- as well as increases in revenue and changes in the tax code.
Some of the proposals discussed include shifting costs to Medicarebeneficiaries or reducing access to care. Even though the new Health Care Reform bill has expanded preventive care for Medicare beneficiaries, I believe that eventually the high deductible Medicare Supplement insurance concept will gain support because now Medicare beneficiaries can go to their medical providers with unlimited access.
If one has a high deductible Supplement insurance plan and isrequired to co-pay for part of the cost, these number of visits to doctors will be reduced significantly. I know because I’ve moved to the high deductible plan, and now I am very selective on when and how often I see doctors because I know that I will pay for part of the cost up to $2000.
At least this concept makes sense to me and that’s why I’mencouraging clients to look at the high deductible plan and be ahead of the game… because Medicare cannot continue to operate with the existing rules of unlimited access to doctors with no co-pays, if we are going to get a grip on or our nation’s debt.
Please call my Assistant Linda Kaus at 785-537-0366 if you have any questions, but look for your renewal membership reminder in early October. I look forward to working with each of you.
Coach
http://www.mymedicarecoach.com/
Medicare updates for this newsletter made available through The Medicare Rights Center- a national nonprofit consumer service organization Release: Sept 8, 2011)
