Traditionally, from Jan. 1st to March 31st each year, Medicare Advantage (MA) members have had the option to switch to a different Medicare Advantage Plan.

Starting in 2011, the three-month period is shortened to six weeks and is no longer an Open Enrollment Period. It becomes the Annual Disenrollment Period (ADP).

From Jan. 1st to Feb. 14th only, Medicare Advantage members may disenroll from their Medicare Advantage Plan, but cannot enroll in a different Medicare Advantage Plan. Their only option will be to return to Original Medicare and select a traditional Medicare Supplement and/or a Part D Prescription Drug Plan.

The Annual Enrollment Period from Nov. 15th to Dec. 31st is not changing for 2010, but it will be especially important for Seniors to make the right decision during this time period. If they select a Medicare Advantage plan, in most cases they will be locked into that plan for a whole year until the 2011 Annual Enrollment Period. If a Senior decides to switch from an MA plan to a traditional Medicare Supplement, what’s the value for them?

• Traditional Medicare Supplements provide Seniors the freedom to choose whichever doctor or hospital they want.
• A Medicare Supplement from any Company we write with is guaranteed renewable as long as premiums are paid on time.

I highly recommended that you review what you have over the next 30 days. Feel free to contact me and I will help you with this.

Each fall Medicare announces its deductibles and co-payments for the following year. The 2011 deductibles and co-payments have been announced. The biggest increase is an additional $32 for the hospital Part A deductible that must be paid for each hospital confinement that begins a new benefit period. The HDF and F+ high deductible amount did not change and remain at $2,000 for 2011 the third year in a row. (See Below)

These modest increases, in comparison to other things going on in the industry, further highlight that a person is generally served best by having Original Medicare and a good Plan F or High Deductible Plan F (depending on their finances and health).

I am here to give individual attention to your needs. Call me and I will help you decide which company has the best plan to serve you.

2011
Hospital Part A Deductible for first 60 days $1,132 ($32 increase)
Copayment for days 61-90 $283 per day ($8 increase)
Copayment for days 91-150 $566 per day ($16 increase)
Medicare Part B Annual Deductible $162 ($7 increase)
Annual Deductible HDF and F+ $2,000 (NO Change)
Plan K annual out-of-pocket limit $4,640 ($20 increase)
Plan L annual out-of-pocket limit $2,320 ($10 increase)

I’ve been writing this blog for sometime. Sometimes it is not apparent what I should include in my subject matter. Starting today, I will begin answering questions people have via posts on Facebook with a simultaneous link on Twitter and here on my Agency’s Blog. No names will be used. When there is personal information, it will be taken out of the public post (but included in your private one which will be emailed back to you).

Email your questions to michaelpmyers@gmail.com or call me 209.390.1163.

A little published provision of the so-called Health Care Reform, is a provision called CLASS. This is ostensibly to provide a level of Long Term Care benefits to all Americans.

The actual portion of this bill reads like this: (but please keep reading)

STATED PURPOSE OF THE BILL (Sec. 3201)

The bill provides a very modest amount of daily cash as a benefit (much less than what is typically required), and a person must pay for FIVE years before there are any benefits. It is my understanding that if a person opts out and does not pay in, they cannot come in later. Actual rates are not yet published, but are expected to be higher than what is traditionally available from private insurance.

So that I am not misunderstood: Long Term Care benefits are needed. However, is there a better way?

The answer in almost all cases is: YES!

I encourage you to look at this and ask me for more information. I can provide you with a way of taking care of Long Term Care needs (should that need arise), while at the same time providing living benefits for yourself should you get injured or sick, or should you have to deal with a life changing critical illness (like Cancer) – and at the same time, provide a death benefit for your spouse and/or children!

Call me (209.390.1163) or email me (michaelpmyers @ gmail.com) for more information.

Michael Myers

Being in the insurance industry since 1978, I have listened to people’s concerns. And I understood.

• “I pay for life insurance, but I never get any benefit from it.”
• “Yes, I need Long Term Care Insurance, but I can’t afford it.”
• “I am worried about getting hurt or sick and not being able to work. But I can’t pay for life insurance and disability income insurance. It’s one or the other, so I guess it’s like insurance.”

In times past, I could understand why a person could feel that way. But today’s policies do more than yesterday’s policies.

I have a policy that I’d love to show you. It’s life insurance – but it’s also long term care insurance (and you won’t believe how good it is!), it’s also critical illness (cancer, etc), and it’s also disability income. You have got to see this for yourself!

If you work in law enforcement, or for the state government, you really need to look at this and compare it to your present program(s). You will be very pleasantly surprised!

Call me (209) 390-1163 or email me (michaelpmyers@gmail.com) and let me show you how good it is. You may even save money from what you are presently doing … it’s that good!

Michael

Disclaimer: From a legal standpoint, this is a life insurance policy. But it does the things I describe. This post is not intended to be a legal description. I provide that at the time of illustration (or before on request).

I’ll tell you the complete unvarnished truth.

Take for instance all the talk about bad insurance companies. Now, there is no doubt that there are some bad apples out there. But is the talk you hear in the news really honest and truthful?

For instance …

So whereas I cannot do anything about all the rhetoric (I wouldn’t even try), I can help you by telling you the truth. I give my clients good advice, based on their circumstances. And I’ve been doing it for 30 years.

Call me at 209-390-1163 if I can answer any questions for you. I’m here to help.

Michael Myers

Can this be done? In almost all cases, the answer is yes. This will work in groups of 2-50 and the principles of this can even be done by individuals.

I have tried to write a post on how this is done, but my post includes a graph that compares the typical PPO that most people purchase with my Out-Of-The-Typical-Box solution. Unfortunately, if there is a way to put a graph into a blog post, apparently I do not know how to do it.

But if you’d like to know more, please call me 209-390-1163 or email me at michaelpmyers @ gmail.com and I will send the complete post.

I am excited to announce that by combining two company’s products, I have found a new way to save the average small business (down to 2 people including husband and wife firms) a whopping 35% or so. And the benefits are often better! This is so good you’ll be amazed! Call me for more information.

Sometimes people will continue working primarily due to feeling the need for health insurance. This is understandable, in view of the uncertainty today.

When a person does reach Medicare age, questions often arise. Questions like:

1) What is original Medicare?

2) What are Medicare Advantage Plans?

3) What about prescription drugs? And finally …

4) What about Long Term Care?

Original Medicare is broken into two parts, Part A (Hospital) and Part B (Doctors and other things). Part “A” comes with Social Security and you do not pay for it. Part “B” you do pay for, as it is subtracted from your Social Security Check. Some people qualify for help with this premium, while others pay more (due to large incomes). Most people pay $96.50 for Part “B”. Some people elect not to enroll in this, but I believe that almost everyone should enroll in Part “B”. It is the best deal in health care today.

Medicare Supplement Plans (sometimes called MediGap policies), pay on the deductibles and co-pays that Medicare does not pay. They only pay on expenses that are “covered” by Medicare. In other words: if Medicare pays something for the service, then MediGap policies have a benefit. Conversely, if Medicare does not cover the expense at all, then neither does any MediGap policies.

Medicare Supplement polices are standardized. Each policy has a letter designation, and every company who sells that “letter designation’ has the same policy. So a “Plan F” from company XYZ is the same policy and has the same benefits as a “Plan F” from company ABC. The only difference is the premium and how well a company serves your needs.

I am a big advocate of original Medicare combined with a good supplement. In my view, and in most cases, a person will have the lowest overall medical expenses choosing this option. (Ask me and I will help you decide if this would be true for you). But the best part is a person’s medical expenses are predictable using this option.

You are allowed to enroll without health questions when you enroll in Part “B” of Medicare. The legal time frame is three months prior to three months after (a total of seven months). Some companies choose to allow more time. And some companies allow this at any time on some plans. And in CA, a person can change companies but keep the same plan in their birthday month without health questions.

Choosing Original Medicare with its Part “A” and Part “B” along with a MediGap policy is felt by many (including myself) to be best for people who wish to know exactly what their health costs will be or for those who travel a lot.

Medicare Advantage Plans are also known as Medicare Part “C”. It is essentially the privatization of Medicare. A person still pays for Part “B”, but could pay anywhere from Zero dollars to around a hundred dollars per month for the plan. It is different in each County. Although it is Medicare, these plans work a little more like a person may be use to coming off a group health plan. Typically, you will have co-pays and the like, with a maximum out of pocket. You do not know what your total costs will be, but you do know the maximum it could be (which is typically considerably higher than staying with Original Medicare and a supplement). These plans differ somewhat in that a doctor may choose to accept it or not, and may in fact, choose to accept you this week, but not next week. He may choose to accept your best friend, but not accept you. A physician cannot do this with original Medicare, but it is legal for him to do this with Medicare Advantage Plans. They refer to it as “deeming”. A decision to accept you does not establish a policy, but rather a decision made on each visit. Just so you know, it is not common for Physicians to do this, but it can and does happen for reasons beyond anything you have control over.

Medicare Advantage Plans operate under very strict enrollment procedures, but a person needs to know that each year, for the last six weeks of the year, a person can change their plan, or return to Original Medicare, if they choose. There are other times, under various rules that allow changes. Ask me for it, and I will give you the complete rules regarding this.

The important thing to understand is that a person does not give up Medicare when enrolling in one of these plans. However, there are rules that must be followed and it is in a person’s best interest to review this each year, as under current CMS (Center for Medicare and Medicaid Services) rules, the plans may change each year. I cannot stress enough the need to do this if a person chooses a Medicare Advantage Plan. The changes can be drastic.

Medicare Advantage Plans, in my view, are not a good option. However, there are exceptions to this statement. If appropriate, they are usually best for people; 1) who wish to keep premiums low, 2) do not mind taking a risk on the total potential out of pocket, and 3) do not travel a lot.  Some counties still have zero premium plans available, which covers a person as well as they may be use to under their group insurance plan (of course, each plan is different and a comparison should be made).

Prescription Drugs are covered under Medicare Part “D”. These plans are typically sold nationally (as opposed to by County). They can be included in Medicare Advantage Plans or purchases separately. It takes quite a lot to explain these, but suffice it to say that there are quite a few differences between plans. The design of these plans came out of Congress, and I cannot explain the rationale behind the design, as I find the design illogical. However, I can show you, not only a good plan for you, but also how to utilize the plan to best serve your interests which means, to save you money.

Long Term Care is really a separate subject. Although Medicare does have a Limited Benefit for Skilled Nursing, the two operative words are “Limited” and “Skilled”. It is good for short stays while a person is recovering and making progress. Basically, it is for those instances where a person is not sick enough to be in the hospital, but still needs some care while recovering. It is not for long-term convalescent care. This type of coverage can be handled in a lot of different ways, and which way is best for an individual will depend on their financial situation, married or not, and a host of other factors. The only constant is planning is needed. The decision cannot be made at the time of need, or at least not made well.

There are 636,000 Medicare Advantage Plan Seniors that are being cancelled. About half of those enrolled in Medicare Advantage plans in my county are being impacted by this.

Now its true that some will find other plans to select from. But its important to understand that of the approximately 9,500,000 seniors still covered by Medicare Advantage Plans; many of these seniors are facing reduced benefits as many Medicare Advantage carriers are LOWERING BENEFITS TO SENIORS!
 
Simply stated, over 10,000,000 seniors are being impacted by the decisions being made in Washington.
 
I saw much of this coming, and this is why I have for a very long time advocated that Seniors – in most cases – are far better served by staying with Original Medicare and purchasing a separate, stand-alone, Part D (prescription) plan.

With the right Medicare Supplement, many, if not most, people – even after paying premiums – will have less out of pocket on health care costs.

For those impacted by this, (with a copy of their disenrollment letter), Medicare Supplements will be Guaranteed Issued with no waiting periods for any pre-existing health conditions. Everyone qualifies!

But even if this is not the case, let me help you decide what product serves you the best. I am here to help. Call me (209-390-1163) or email me today.