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.

A recent experience got me to thinking…

Our local grocery store is owned and managed by a nice family. The family has been in the community for over 100 years. Apparently they rely a great deal on their delivery people to “decide” what they will carry in their grocery store. I do not know why they choose to do this, but, convenience aside … I think they make a mistake by allowing others to decide what products they will carry.

Why do I say this?

Here’s an example:  My family enjoys a particular brand of Chocolate Chip ice cream.  Apparently we are not the only ones, as it is usually the first flavor to sell out at the local market.  Now, the way I see it – “supply and demand” dictates that if a product “sells out” consistently – you might want to stock more of it and less of some other flavor that doesn’t sell as well.

Not at our local market.  At our local market when the demand increased for this particular item – the ice cream delivery person simply stopped stocking it. This makes his job easier I guess.  So now, when he delivers his stock, there is not as much he needs to unload.  I can only surmise that the delivery man must be a simple wage-earner.

Now I assume my local market earns money on each item sold. But I have noticed that they follow this same logic with other popular items they sell.  If it sells well, evidently in order to not have to stock quite so often, they just don’t carry it any more.   I guess your store shelves remain filled this way, you require less personnel for stocking, and the quiet, easy going manner in which you’ve always operated remains uninterrupted.  More time for fishing that way.

Here at mpmyers.com – we do not reason this way. We are here to serve you, our client. This means we are willing to work for you.  We sell you – not what is easiest for us – rather what our clients want and we work very hard to obtain exactly what you need. We take that very seriously, and we have for 30 years.

Next time you have an insurance need – call me. If I don’t have it, or can’t get it, I will likely be able to direct you someplace where you can get it. I won’t try to sell you Rocky Road – when what you want is Chocolate Chip.

You Need a Budget

Keep reading. I promise you this makes sense and there are health insurance options for you out there.

We all need to budget.

Why?

It makes sense for YOU to be the one who decides how to spend your hard-earned dollars.

Quite likely, most have been in that situation where we feel like we’re just putting out “fires.” As soon as we have one doused we turn around and there’s something else that needs immediate attention because it’s about to burn the place down so now all of your resources are aimed at putting that “fire” out.

That’s letting the figurative financial “fires” determine how you spend your money. It’s exhausting. And consumes too much energy and resources – and all too often the important stuff gets postponed. Like health care.

Now, it’s a given – health insurance is not “cheap”. Health care is expensive too. The government continues to come up with new and innovative Band-Aids for the whole health care system.   Time will tell what will come of all of that.

Meanwhile there’s really too much at stake to postpone taking charge of YOUR health care.

One of the most affordable options can be a high-deductible, HSA-qualified health insurance plan.

What??

Why bother with an insurance plan with a really high deductible? You’ll be buying insurance AND STILL having to pay for the doctor, right?

This is what I want you to do. I want you to reframe that thought. Do you have a home? Do you make payments on your home? Do you pay the taxes on your home?

Why do you do that? Likely because you like your home and you want to keep it. You are protecting your investment – because if you don’t pay those things, you could lose it. Think of a high-deductible insurance plan as yet another way to protect your investment. If you get sick and have a major expense (and it does not take much to qualify as “major”), health insurance will keep that particular “fire” from consuming your most valued asset.

So…how do you AFFORD health insurance on top of everything else in this miserable economy?

Careful planning and choosing the right insurance policy can make health insurance affordable. You may be surprised to find that there are health insurance options that will fit your budget and and give you the peace of mind you need as one more way to protect your assets.

One option – an H.S.A.

What is an H.S.A.?

It stands for Health Savings Account. It is provided for in our tax code to allow a person to have a high deductible health insurance plan, and also contribute tax-deductible money to a Health Savings Account (at a bank). Money going into the account is tax deductible. Any money coming out of that account – when spent on health care (i.e. paying the doc from this account) is not taxable.

Another benefit to funding your H.S.A. – if you are in the 28% tax bracket, and you do fund the account and you do pay medical expenses from this account, it is as if you are paying the doctor, dentist, optometrist, chiropractor – whomever your helath care professional may be – with 72 cent dollars. I’ll bet you like the sound of that! Your health care is CHEAPER!!!!

But what if….

What if I cant do it? What if I can’t get my H.S.A. funded with enough $ in it to cover my deductible? Now what good would it be to have purchased this high-deductible insurance policy?

OK…let’s just come up with a hypothetical situation here. I’m not suggesting or recommending you do this – but let’s talk about this particular “what if?”

You’re self-employed.  You end up injured on your job, or that funny pain in your gut turns out to be a bad gallbladder/appendix – whatever. You land in the hospital. You have insurance, so at least they TOOK YOU as a patient right? But oh no…the deductible is terribly high.  You know you don’t qualify for any of the charity programs because you own your house and your business etc.  This sure does look like the straw that will break the camel’s back. Oh worry. Why didn’t I at least save for that blasted deductible?  Or… Why didn’t I just bite the bullet and pay for a more expensive policy? How fast can I get out of this place?! Worry. Worry. Worry.

You leave the health care facility with a payment plan – which you now add to your budget. Each month you’ve agreed to pay the health care facility $100 – or whatever. Why don’t you just put that $100 in your H.S.A. and pay them out of THAT account? $100 in (tax-deduction for you) – $100 out – paying back the debt to the hospital – no penalties for withdrawal from H.S.A. because it’s for a medical expense you incurred after establishing your H.S.A. – if you’re in that 28% tax bracket – you’re paying them back with a .72 dollar.  It’s not the best way to plan for the future – but it’s still better than NOTHING.

Did you know?

When you turn age 65 – ANY money that has not been used and is still in your H.S.A. can now be converted to an I.R.A. and used for retirement purposes.  Again:  No penalties or taxes?

I can help you with this.

Call me or e-mail me and let me explain what’s available. You might just be surprised that it actually will fit into the budget.

Check it out.

• Budget Software – I use it but I’m not affiliated with YNAB. They make budgeting EASY and maybe a little fun.
• Contact Michael about Insurance and HSA options.

One of the biggest challenges facing us today is the cost of prescriptions. There are many people whose drug costs are just short of astronomical.

If you have a need to reduce your costs, and you live in California, try this FREE prescription discount card. (No strings).

I do need to make clear that this is NOT a replacement for your group insurance drug benefit, nor does it replace the need for a “Plan D” prescription drug benefit if on Medicare. But it can be used through the so-called “donut hole” to reduce your expenses.

I hope this helps you. I would appreciate knowing if it does.

Without being political, I cannot allow my readers to believe that what is being widely reported by the traditional news organizations is truthful. It is not. I have noted repeated misstatements and what I call endrounds (that is saying something that may be true in itself yet serves to obfuscate the listener).

The Health Proposal in Congress is long. Few if any know everything that is in the bill. However, a Duke Professor did an analysis on it and I thought it worth posting. He allows the language in the Bill to speak to the questions. No interpretations … just a reprint of what is in the Bill.

http://www.classicalideals.com/HR3200.htm

This in no way addresses all of the concerns people have about this issue, but it does a pretty good job addressing some of the false reporting going on by those who seemed to have forgot what the word “reporter” means.

There is a lot more to this, but my pupose here is to educate, not editorialize. But, if there is anything I can answer for you, please do call me or email me.

Michael Myers

In many states, Blue Cross and Blue Shield seems to be the same company. In California, Blue Shield and Blue Cross are not the same company. Why?

Neither Blue Cross nor Blue Shield are “Insurance Companies”, but insurance companies license to do business under those names. Blue Cross Blue Shield Association may license one insurance company under the Blue Cross name and another insurance company under the Blue Shield name. In many states, the same insurance company secures the licensing right to use both marketing names, but in California, this is not the case.

Until recently, Blue Cross in California was known as Blue Cross of California. Recently, their parent (WellPoint) changed their name to Anthem Blue Cross – to more closely match the Anthem Blue Cross Blue Shield name they use in some neighboring states.

However, Blue Shield of California is a different company not owned by WellPoint.

Which company is better?

It all depends on what type of plan you wish to have, and your age and gender.  One company will be better for one, while the other is better for another.  Blue Shield of California has a high rating from the independent insurance-rating service “A.M. Best“.

If you are young, you may like the Tonik plans from Blue Cross.  They are pretty straight-forward plans, and simple to apply for.

I still strongly recommend – to my clients who will make best use of them – an H.S.A. (Health Savings Account) Qualified Plan. And I have several companies, including Blue Shield and Blue Cross who write these plans. I also offer the Farm Bureau Plans from Health Net. Sometimes … they prove to be the best.

I offer links to all these sites here, or if you prefer – email or give me a call, I’ll be happy to send back a report comparing them for you.

My wife has a kid brother. He was born when his siblings were all entering their teens, so as teenagers always seem to do – they had lots of fun with the “baby.” I’m told he had a habit of innocently asking their mother at meal time, “Mama, do I like this?” His mother would assure him that he “liked” whatever it was on his plate, and he would then begin eating his meal.

The same thing happened at other times – times like when they were having a treat of some sort. “Mama, do I like this?” He’d ask. “Oh absolutely,” his mother would respond, and then he’d discover the newest “flavor of the month” or whatever treat was being experienced. Obviously, he trusted his mother’s opinions.

The teenagers, of course (my wife included), thought of all the times they were told it didn’t MATTER if they liked it or not – eat it. But those were different times, and this was, after all, “the baby” of the family.

Soon, though, the teenagers decided to have a little fun with him. The next time he asked the question over something maybe THEY would be happy to eat for him they jumped on it. “Mama, do I like this?” he asked. “OH NO! You don’t like it at all, they chimed. Here, I’ll eat that for you!” And he obligingly handed over a cookie or the newest flavor of the month at the ice cream parlor. Of course, “Mama” eventually put a stop to such shenanigans, and he grew up to be a fine man despite his siblings.

What’s all that got to do with donut holes?

Well, you might be asking a very similar question as my brother-in-law once did if you hear something about “donut holes” when your Medicare policy is being explained to you by your trusted insurance agent. “Do, I LIKE donut holes?”

And the answer to that question is,  well… “it depends.” It depends on which ones we’re talking about. Are we talking – sweet, deep-fried middles of pastries here? Then, I’d be willing to say “Yes!”

If we’re talking about an insurance “donut hole” then  I’m betting “No,” you don’t like those.

Just what in the heck IS an insurance donut hole anyway? It’s a term applied to the period of time in “Part D” of Medicare (that is the prescription plan) where the plan pays zero, zilch, nada (although, actually some plans do pay for generic drugs through this period) – and you have to pay out of your own pocket for your medicine.  This period of no drug benefit begins when your prescription drug costs reach $2700 (some plans start earlier) – until you have total costs of $4350. The amount between $2700 (or the lower amount) and $4350 is the donut hole. After this, catastrophic coverage kicks in and this benefit is, in general, pretty good. But that donut hole – ouch! – we didn’t like it…did we?

If your plan has a “donut hole” in it – how can you make that kind of donut hole more palatable? You must plan for it. When your prescription drug costs hits a certain amount in a year, you will hit the donut hole. So the smart thing to do is budget for that period… sorry, but it’s a necessity if you have drug costs that exceed $2700 in a year.  Whether you are told you have a monthly deductible or not, if you spend more than $2700 per year on prescription drugs, you DO have what amounts to an annual deductible. That “deductible” can be calculated as the initial deductible (some plans have an initial deductible of $295, some don’t) PLUS the “donut hole” – that’s the amount you spend after you hit the $2700 limit and when your plan picks up again paying.

Now take that total amount and divide by 12, and that is how much – in addition to whatever premiums you pay and co-pays you pay – that you need to budget each month in a year to cover your total drug costs.  For most people this likely is not going to be an issue, but for some who have excessive drug expenses – be sure to do your best to plan for this “gap”.

Hopefully, I’ve helped you understand this feature at least somewhat better. Clearly, they were taking their analogy from the empty space part of a donut – not the sweet little nuggets of pleasure to occasionally accompany a hot beverage.

I’m still betting you won’t like this kind of donut hole, but planning (budgeting) for it can at least make it a little easier to swallow.

I am always here to answer your questions and help guide you in the selection of your prescription drug plan, so give me a call or send me an e-mail, we’ll talk.

Medicare Advantage season was over before it began, so far as I was concerned, as the Annual Enrollment Period runs from November 15th to December 31st and the regulations got pulled on November 14th. Lots of issues over commissions and the like with certain ones acting like we insurance agents are getting rich selling this stuff. Nothing could be further from the truth. We have hours and hours invested EVERY year to certify to enroll people during the current season. Nothing else in the industry, that I know of approaches this level of time investment by the agent, with so little compensation. No one pays for our time to do this. And then the restrictions on marketing get more and more restrictive. And as for commissions, no one is getting rich here. They could only be described as low to very low – especially when you consider what a person goes through to offer them.

And as irritated as I am, personally, by all of this, I think Seniors should be even more irritated. Rules and rules and more rules – with notices after notices that no one is going to take the time to read, much less know what it means.

I have my doubts that these plans will continue for very much longer, at least not without serious changes.

Having said this, it is to be acknowledged that there are definite advantages to these types of plans – for some consumers, but how anyone finds out without talking to someone – like myself – who will tell them the truth – about all plans available, not just the ones you can sign up for at the drug store or some major retailer, I have no idea.

Every person is different, and which plan is best for them depends on unique circumstances. But plans made available in major retailers – usually is contractually limited to one or two plans, and in addition to this obvious issue that is not in the consumer’s best interest … ask the agent how long he/she has been licensed. In most cases, not long.

I have been working with Medicare Supplements for over 30 years. I believe that some people are best served by Medicare Advantage products (in spite of all the hassles), but many – if not most – are best served by traditional products.

I can help you, but due to all the regulation, I need you to ask me. I will guide you through it.

And keep in mind that CA has a rule that allows you to, in many cases, switch Medicare Supplement plans without underwriting 30 days from your birthday.

So if you have a birthday coming up – why not let me offer you my services? It won’t cost you anything – and likely will save you money.

If you own a company¹ and provide health care coverage for your employees, how can you choose good coverage, and yet not send your company to the poorhouse?

Have you ever considered a Health Savings Account-qualified plan?  In recent years, many companies have moved to HSA’s to save money. This is a good thing, but what are they?

An HSA-qualified health plan is a high-deductible health insurance plan that is “married” to a bank account called a Health Savings Account.  HSAs are owned, and funded by either the employer or the employee, but are always owned by the employee even if the employee changes employers.  They provide tax savings for the employer and the employee. Sounds like a great arrangement, yes?

It is!  Yet, there is kind of a drawback to them – sometimes employees fail to learn enough about how their HSA works to make good decisions when implementing them.  They neglect funding their HSA and then, when they incur medical expenses, they have this (affordable) insurance plan with a high deductible, but no “savings” to pay their share of cost.   Like any tool, if not used right, it won’t get the job done.

Please Note:  HSA’s should not be confused with Cafeteria Plans (Section 125 or “Flexible Spending Account” Plans) where the employer controls the account.  With these plans, an employee signs up for payroll deduction (limits set by the employer) and then has total access to annual funds for expenses at the beginning of the year. The employer advances any monies needed, but also keeps any monies not spent. These plans also have good use (and can be designed to offer child care, etc). They do not continue with an employee after termination.

If you are the employer, the course of wisdom is: when you provide an HSA-qualified medical insurance, ALSO make arrangements to educate your employees on how to fund the savings account necessary to make the program work.

I highly recommend for you and your employees the following:

1. An HSA-qualified, high deductible, affordable, quality health insurance plan.
2. A Health Savings Account that is funded regularly will provide outstanding protection for the employee.
3. Thorough education on how these can be successfully implemented.
4. And, additionally, adding another “layer” of voluntary coverage, benefits that cannot be matched by any other system I know of…

…all with tax savings and affordability for both the employer and employee.

Let me explain it more thoroughly.

Email me or phone me and I will explain how this concept can work for your company.

I will save you money. And just as important to you, I will educate your employees.

Michael Myers
CA License 0561502

¹ Or if you are the Human Resources Manager in charge of implementing health care plans.

There was a story on the PR Newswire dated August 18th that talked about the growth of CDHP’s (Consumer Driven Health Plans). These plans typically have higher deductibles, and are often put together with a health reimbursement account (HRA) or a health savings account (HSA).

Both of these stategies will help keep an employer’s costs down. However, this is not the only choice.

I offer both choices to my clients, but also another choice that is VERY COST EFFECTIVE and very popular with employees.

Let me show you how you can cut your medical insurance costs by 15 to 40 percent. Click on my picture to the right and then call me or email me off the links on my main page.

Michael P Myers