Medicare 411

Tracey Fults



The following articles, originally published in the print edition of SN50, were written by Tracey Fults,a fully licensed Life and Health insurance expert specializing in Medicare. She brings more than 20 years experience in the
insurance industry and is the founder/owner of Medicare 411.

What To Know About Medicare Supplement Plans

Reader Denise C. asks: “I have a Medicare Supplement Plan F with XYZ company, and just got a rate increase.  Do I have to wait until Medicare Open Enrollment to look at lower cost options?”

That is a great question, and the answer is NO!  Medicare Supplement plans are not a part of the Annual Medicare Open Enrollment period.  You can shop for a new plan right now!

Medicare supplement rates are generally based on your age, gender and where you live, and prices vary from company to company.  The plans are standardized coverage so that means that a Plan F is a Plan F regardless of what insurance company you choose to use for your supplement.  When working with an Independent Insurance Agent they should be able to provide you competitive quotes from multiple companies and it is their job to make certain the company is financially stable, easy to work with and has competitive rates.

When you change Medicare Supplement plans, there is a process called underwriting that occurs with most supplement companies.  This is a list of health questions that are asked by the agent and then provided to the insurance company along with your medication list and typically your physician’s information.  The application is then reviewed by an underwriter and the insurance company will either accept or decline your coverage with them.  The process generally takes a week to ten days and every company’s list of questions tend to be a little bit different, so it usually isn’t difficult to switch unless you are in the middle of a substantial health event or have a serious chronic illness.

Medicare supplement rates do change typically every year as we age, I call it the “Happy Birthday” rate increase, however, it is important to check your rate every few years to make sure you aren’t paying too much.  With the Baby Boomers becoming Medicare eligible, the Medicare Supplement market has become very competitive and insurance companies have lowered rates in the past few years to attract those individuals turning 65 which is great for the consumer.

Switching from a Medicare Supplement to a Medicare Advantage plan would require you to wait until Medicare Open Enrollment which runs from Oct. 15 to Dec. 7 and this is also an option for people whose Medicare Supplement rates are getting too pricey for their budget.
Happy shopping Denise!  Until next month dear readers, STAY WELL!

How Much Does It Cost To Be On Medicare?

Reader Fred K. asks: “How much does it cost to be on Medicare?” 

Dear reader Fred K., the answer to this question varies somewhat depending on your age, where you live, the type of plan/s you select, the medications you take, and your income.  The following is based on a 65 year young gentleman living in the general Winnebago/Boone Counties area whose taxable household income is less than $170,000 for a married couple:

Your first cost is the monthly Medicare Part B Premium is currently $134.90 per person, this is a cost that is not based on gender, age or geographic location, it is set each year by CMS (the Centers for Medicare and Medicaid Services.) If you are receiving your social security then this will be deducted from your monthly check, if you are not currently drawing your social security or do not receive social security you will be billed quarterly by Medicare for this premium.   This premium can change each year.

Next, the type of plan you choose to go with your Medicare falls into two categories:  1. Medicare Supplement or Medigap plans and a Part D prescription plan or 2. Medicare Advantage Plan, also known as Part C of Medicare.  

Medicare Supplement premium for a 65 year young gentleman is currently around $135 per month for a Plan F which is 100% coverage after Medicare and then you need to add a Part D prescription plan which is a separate coverage and in 2017 the average monthly premium is $34.00 per month. Your total monthly premium cost would be $303.90 per month.  There could be costs at the pharmacy when you fill medications and this is very specific to the medication you are prescribed.

Medicare Advantage plans typically have the Part D built in to the health plan and can be as low as $0 monthly premium.  When you go with a Part C plan, you are putting your Medicare coverage with a private insurance carrier who manages your Medicare claims. Medicare Advantage plans have co-pays or co-insurance that you pay as you utilize your healthcare coverage throughout the year.  While you might pay $0 premium, or a low premium you still pay the $134.90 per month directly to Medicare and there will be out of pocket costs throughout the year for seeing your doctor, going to the lab, visiting the hospital, etc.  

By visiting with an independent Medicare certified insurance advisor, you can look at all the options side by side so you can make an informed and educated decision about your Medicare coverage.

Hope this helps as a starting point for your health insurance budget!  Until next month dear readers, STAY WELL!

Turning 65 And Understanding Medicare

Reader Janice B. asks: “I am turning 65 in September and I am getting bombarded with mail and phone calls already, when do I have to make decisions about Medicare?”  

Dear reader Janice B, the answer to this question depends on your health insurance status.  So, I will provide two different answers:
1. If you are on employer coverage and your employer is larger than 20 employees, you only need to enroll in Medicare Part A to stay on employer coverage.  If your employer is smaller than 20 employees you will need to enroll in Medicare Part A and B to stay on your group coverage and you should compare the costs of your group plan to being fully on Medicare.  

The time frame for this is generally 60 to 90 days in front of your birthday and you can enroll in either Part A only or Part A and B of Medicare online through the website.  If you are already drawing Social Security, the Social Security Administration knows that you are turning 65 and your Medicare card will come in the mail about 60 days before your effective date.  

When you have the card, you can opt out of Part B if you don’t need it to stay on employer coverage.
2.  If you have individual health insurance or are on Cobra then you will need to enroll within that 60 to 90 day window as well and the Social Security statement above still applies (your card will be automatically mailed to you.)  

Also, within this time frame you can shop supplemental coverage or Medicare Advan-tage, Medicare Part D plans you may need.  
Medicare always starts on the first of the month so with your birthday being in September, your effective date will be 9/1/2017 unless your birthday is the first of the month, then your effective date will be 8/1/2017, so your time frame to enroll and make decisions begins either this month or next, which is why your mailbox is full and your phone is ringing.
Reaching out to an independent full service insurance agency who represents all options tends to be the easiest way to do your research, as you will be able to compare everything at one time instead of trying to check out each option separately.

Happy early birthday Janice and welcome to Medicare!  Until next month dear readers, stay well!