Want to save money on your group insuance?
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.
How To Reposition Your Insurance Dollars to Protect Your Most Important Asset
I write a lot to those retired. But I’d like to spend a little time talking to those of you still working.
What is your most important asset? Your home? Perhaps your health? What about your income?
Do you know anyone who has or had cancer, a heart attack, or a stroke? How about chronic backaches? Were you aware that conditions of the bones, joints, and muscles — such as bad backs or arthritis — are the leading cause of disability today? Did you know that cancer is the second leading cause of disability claims?
Why is this important? Because the chances of us facing such a reality is really quite high. We call that our PDQ – Personal Disablity Quotient. (Click on the link to figure your PDQ).
But if you have not protected your most important asset – all is not lost. I very likely can show you how to re-position the dollars you are currently spending to protect all the things that matter – and not leave out your most important asset in so doing.
Call me at 209-390-1163 or email me (michaelpmyers @ gmail.com) and I’ll show you what I can do for you.
Medicare: A Basic Understanding
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.
Why I Prefer Medicare Supplements over Medicare Advantage Plans
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.
Good service means supplying the customer what they want.
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.
