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Get Ready to Help with Medicare Insurance Decisions

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This is the time of year when people on Medicare prepare for open enrollment.  And you thought you were done with that when you left the workforce.  But, Medicare has an open enrollment period each year for Medicare beneficiaries who want to enroll or change Medicare Advantage and Medicare Part D plans.

 For many of us in the sandwich generation, it’s a time when we lend a hand to an aging parent or family member to figure out if they need to change plans – either for cost reasons or because their medical needs have changed.  It can be pretty confusing no matter what your age.  But it really is worth taking the time to compare plans and make sure you’ve got the right plan and the right price.

 The good news is that prices for Medicare Advantage and Medicare Part D plans won’t be changing much from 2010 to 2011. 

Plan prices will be about 1 percent lower, according to the Centers for Medicare & Medicaid Services. 

You may still have to shop for a new plan during open enrollment – if the plan has changed benefits, health care needs have changed or the plan is exiting the business. It’s also smart to check and make sure the plan you’ve got is still the right plan.  During this special period you can switch plans without having to worry about health conditions limiting your choices.  This period doesn’t apply to Medicare Supplement Plans.

 Those who have Medicare Advantage plans or Medicare Part D plans can change their plans during the Annual Enrollment Period (AEP) from Nov. 15 – Dec. 31. 

Longevity Alliance, a national insurance brokerage, is offering an AEP Reminder service.  You can sign up to receive an email when most of the 2011 plan information is available.  That way you won’t have to keep calling to find out about rates for 2011 and you won’t let it slip!  You can sign up for the free service by clicking here.

Rate and plan comparison tools are available at  But the 2011 rates usually aren’t loaded into the system until mid-late October.  So keep checking back and make sure you are looking at 2011 rates. 

“Even with the lower costs, all beneficiaries should take time this Fall to compare their current health and drug plan coverage with what’s available and best meets their needs for next year,” said Jonathan Blum, deputy administrator and director of CMS’ Center for Medicare.  “Medicare will continue to provide a wide-range of consumer tools to help beneficiaries make the best possible choice of coverage.”  

Rates and benefits for specific 2011 plans are generally released between Oct. 15 and Nov. 1.  The government rules say you can’t buy a plan until Nov. 15, but you can start shopping and comparing rates so you don’t end up in a last-minute rush.  And you’ve got to shop to save and/or make sure you’ve got the right plan for your current medical needs.

 Don’t wait too long. The companies handling this business get very busy.  You’ll get more attention and assistance, if you need it, if you look early in November and apply as soon as you can – November 15.  And make sure you compare plans and fully understand the co-pays and network limits since a low-cost premium may just shift costs  and you’ll find you’re paying more at the doctor and the pharmacy.


Written by Laura Rossman

September 23, 2010 at 1:17 pm

Preparing for the Medicare Shopping Season

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Medicare Part D Covers Prescription Drugs


Medicare Part D Prescription Drug plans will cost about the same in 2011 as they did in 2010 according to information released yesterday by CMS (Centers for Medicare and Medicaid Services).   

Good news for Medicare beneficiaries.  And good news for sandwich generation adult children who assist senior family members or aging parents with making Medicare plan selections. Maybe fewer will face the confusion of changing plans.   

But don’t assume the 2010 plan is still the best plan for your health care needs.  You’ll still want to shop and compare plans – and watch out for changes in the co-pays that can boost out-of-pocket expenses.     

This announcement marks the start of the Medicare shopping season also known as Annual Enrollment Period (AEP).  Medicare beneficiaries can change Part D and Medicare Advantage plans only from Nov. 15 – Dec. 31 for plans effective in 2011.  You can’t do much with the information yet.  But come mid-October there will be specific plan information available on the government website so you’ll be able to compare you current plan with 2011 plans.  

Here’s the schedule leading up to AEP:   

September –Information about premium and benefits for each Part D and Medicare Advantage plan  

October – More detailed plan information is available so that you can begin comparing plans  

Nov. 15- Dec. 31 – applications for plans effective in 2011 can be accepted  

 Here’s the statement from Medicare on part D premiums for 2011.   

 “Most Medicare prescription drug plan premiums should remain relatively stable next year, and all beneficiaries should compare their coverage under their current plan with the plans that will be offered in 2011 when that information becomes available in October,” said Jonathan Blum, deputy administrator of CMS’ Center for Medicare. “The Affordable Care Act improves the value of drug coverage people with Medicare will receive next year, providing discounts on brand name drugs and coverage of generics in the coverage gap, or donut hole.”

Written by Laura Rossman

August 19, 2010 at 3:33 pm

Shop before you buy Medicare insurance

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If you’re getting ready to sign up for Medicare, there’s a great 3-part series of questions and answers at the New York Time blog “Bucks.” 

Even if you are already a Medicare beneficiary, you’ll find helpful information about new benefits next year and some guidance on the different types of Medicare insurance plans. 

The Medicare Rights Center is the expert behind the answers.  The topics cover the basics to some very specific questions about benefits and coverage for the disabled.

 If you have a Medicare Advantage plan or Medicare part D or think you might want to switch to one of these plans, the Medicare Annual Enrollment Period ( the AEP) is Nov. 15 – Dec. 31, 2010 for policies that will be effective in 2011. 

For most of those with Medicare Advantage plans and Medicare Part D plans this is the one time of the year when you can change your coverage (there are some exceptions). 

Comparing your current Medicare plan to other plans may be especially important this year as changes in prices and benefits are expected. 

Plan information and prices for policies effective in 2011 aren’t available yet.  You’ll have to wait until October.  

But it’s not too early to start reading up on the ins and outs of Medicare. 

If you’re new to Medicare, and must purchase your own plan (no retiree insurance), you may find the cost of insurance is more than you anticipated.   

Here’s what Jennie Phillips at found when her husband turned 65:

“You add all this up and it comes to a minimum of  $257.50 per month or $515 for a couple. It is easy to go much higher if you want plans that offer more bells and whistles. That’s about $100 more per month than we contribute to our current health plan offered through my husband’s employer, including vision and dental insurance, which Medicare doesn’t offer.”  Read the rest of the story here

More evidence that it’s really important to research and find the right plan but also make sure you shop for Medicare insurance.  Don’t look at just one company.  Compare prices of at least 3 companies to make sure you get the right plan and don’t pay too much.

 Unlike your days as an employee where you could choose levels of coverage, but there was only one company offered, you do have a choice.  Make the most of it to get the best plan and price.

Written by Laura Rossman

August 16, 2010 at 2:47 pm

Medicare Supplement Plan Changes Coming June 1

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If you buy your own Medicare insurance or soon will be, you should know about the changes  coming to Medicare Supplement, often called Medigap, plans beginning June 1, 2010.  But you don’t necessarily have to DO anything.

There will be two new Medicare Supplement plans – Plan M and Plan N and four plans will no longer be offered: Plans E, H, I and J. 

So what do you need to do?  

  • If you currently have a Medigap plan, you don’t have to change anything. But you might want to take a look at the new plans if you have experienced significant premium increases. 
  • If you are purchasing a policy that will be effective after June 1, your choices will be limited to these plans, – Plan A, B, C, D F, G, K, L, M, N.
  • If you are interested in purchasing Plan E, H, I or J, you must do it before June 1, 2010. 
  • If you have a Medicare Advantage plan now and think you might want to switch to a Medicare Supplement plan, you’ll generally have to wait until the open enrollment period begins Nov. 15. 

These changes aren’t the result of the recent health care reform bill, but from a law passed in 2003 that happens to take effect June 1, 2010.  And, don’t confuse this with Medicare Part A, Part B, Part C, and Part D.  Those “parts” refer to Medicare itself.  These “plan” changes are for Medicare supplement plans sold by private insurance companies.

Not all insurance companies offer all plans.  And some of the companies are still in the process of getting rates approved for the new plans. 

There’s always been a pretty clear line between Medicare Advantage and Medicare supplement plans.  Generally, Medicare Advantage required you to use a network and included cost-sharing (you pay co-pays when you visit the doctor and deductibles.)  Medicare Supplement pretty much covered the gaps left by Medicare – Medicare paid 80%, Medigap paid 20% — the plans differed by benefits covered but co-pays weren’t part of the deal. 

Plan N is a new plan that has some features that tend to be more associated with Medicare Advantage plans.  Plan N requires you to pay the Medicare Part B deductible ($155 in 2010) and up to $20 per office visit and up to $50 per emergency room visit.  That cost sharing may result in lower premiums, but if you frequent the doctor often, the premium savings will be offset by co-pays for visits to the doctor. Do the math to compare costs, and recognize that health can change in a minute – Are you prepared to pay the higher costs that could result? 

These changes make it more important than ever to shop and compare plans, benefits and total cost. If you are a member of the sandwich generation helping an older adult with their health care choices, make sure you ask a lot of questions before you consider a change to their plan just because of price.  Switching to a new plan may require underwriting.  If you speak with an agent who wants to switch you to a new plan from a different company than your current insurer, ask some questions.

Remember, the benefits of a Medicare supplement plan are the same no matter which insurance company you purchase a policy from — they are standardized.  But the price differences can be different and are from the prices I’ve seen so far for these new plans that start June 1.  Ask questions before you switch companies – about the stability of the company and its history on increasing rates and whether your application will be underwritten for medical conditions. 


To find out more about the changes in Medicare supplement plans,  you might want to read the free white paper “What’s all the noise about new Medicare plans” from Longevity Alliance. 

Buying A Medigap Policy booklet from Medicare– changes described

Written by Laura Rossman

May 4, 2010 at 3:06 pm

Watch Out For Medicare Scams

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There’s a lot of confusion among seniors about what the health care reform does and does not do regarding Medicare.

 And where there is confusion, there are scams.

 Door-to-door and on the phone the scam artists are trying to get Medicare numbers and bank account numbers from seniors,  telling them they need the information to sign them up for new benefits or to make sure their benefits will continue.

 “There is nothing called “Obama Care” and the government doesn’t sell insurance,” Kathy Greenlee, Assistant Secretary for Aging, emphasized in a webchat today on seniors and health care reform. “If they say they are from the government they are scam artists.” 

These scammers are aggressive.  Reports are that on the phone, the caller asks for personal data like social security number, so a new Medicare card can be issued. Refuse and a second person posing as a supervisor gets on the line and says the information must be provided to remain in the Medicare program. Once they have the info, they use it to steal identities and tap into bank accounts.  Hang up! 

At the door, they say they are from the government selling the new Obamacare insurance that is required.  No one from the government comes knocking on your door selling insurance.  Close the door! (and don’t worry about being polite)

 Pass the word on to Medicare beneficiaries you know so they don’t get scammed.  The threat of losing Medicare can make people hand over information they normally wouldn’t.  Seven states –and increasing – are reporting scams.

 Scams should be reported to your state insurance department or office of attorneys general.

 Here are a couple other questions and answers from the session. (A recorded version will be posted at Healthcare

A. What decisions do Medicare recipients need to make now because of health care reform? 

There are no decisions that have to be made right now.  In the fall Medicare beneficiaries will have the opportunity to change plans (Medicare Advantage and Medicare Part D just as they do each year.  The only immediate impact is the $250 rebate that will be provided to Part D policy holders who enter the “donut hole.”  The $250 rebate is automatically issued.  No forms.  No phone calls necessary.

 Q. Will Medicare Advantage be gone by 2014? 

Absolutely not true, Greenlee said.  There will continue to be choices in the future including private plan options. 

Q.  When do the annual wellness exams begin? 

January 1, 2011.

 There are more questions and answers at site regarding seniors, retirees under age 65 and Medicare recipients.

Best advice I heard today was to remind seniors that health care reform doesn’t require them to do anything new today, much less on their doorstep.  There is a lot of misinformation swirling around and especially targeted at the older generation.  If you know someone at risk, alert them to the potential scams.

Written by Laura Rossman

April 22, 2010 at 8:11 pm

College Grads Get Bridge on Health Insurance

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Wondering about how to get health insurance for your college grad until the new law takes effect that will let you keep them on your health plan until they are 26? 

Breathe a sigh of relief if you have a UnitedHealthcare plan (we suspect others will soon follow). 

UnitedHealthcare announced it will extend the health coverage that graduating college students currently have under their parents’ plans until the new health reform provision requiring dependent coverage up to age 26 is fully implemented.

The new law created a coverage gap that was going to send baby boomer parents scurrying for coverage or have their new grads join the ranks of the uninsured.  As part of the Patient Protection and Affordable Care Act, young adults will be able to stay on their parents’ employer-offered or individual family health plans up until age 26. However, this extension does not begin to take effect for employer-sponsored plans until Sept. 23.

 UnitedHealthcare said it is acting to eliminate this coverage gap that some graduating students may face when losing their parents’ UnitedHealthcare health plan coverage upon graduation, and will work with its employer customers to implement the extension.  Other health care companies reporting that they will let parents keep their children on the plans include Wellpoint, Blue Cross Blue Shield plans, Kaiser Permanente, and Humana.

This extension of coverage applies to college students who currently are covered under their parents’ fully-insured health plan offered through UnitedHealthcare. Individual family health plans through UnitedHealthcare’s Golden Rule already allow all dependents to stay on the plan until age 26. 

Now, how is that job hunt going?

Written by Laura Rossman

April 19, 2010 at 8:00 pm

Health Care Reform: What’s in it for Sandwich Generation?

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Now that the maneuvering and rhetoric is dying down (sort of), we’re trying to figure out what health care reform will mean to us – personally.  And for most of us, there just isn’t enough information yet to understand what it will mean to our cost of health insurance or our kids.  

But there are a couple of provisions for the sandwich generation that look to have an immediate impact on older and younger generations.  If you are looking for a good summary of the highlights of the law, try these “explainer” articles from Kaiser Health News.

 Getting young adults health insurance – dependent coverage for adult children up to age 26 for all individual and group policies.  Lot’s of young adults are without health insurance as they were forced to roll off their parents policy and yet to land a job with health insurance benefits.  This give families with insurance a bit of peace of mind as those young adults find work with benefits (hopefully soon).

 Closing the Part D doughnut hole – On the other side of the “sandwich” is Medicare beneficiaries.   There’s good news for those with Part D prescription drug coverage who find they drop into the doughnut hole and facing the full expense of prescription drugs while also paying insurance premiums. If you’ve every helped someone choose a Part D plan or decipher what gets covered or not covered, you know what I mean. 

The law begins to phase out the doughnut hole in 2011 as well as require pharmaceutical manufacturers to provide a 50% discount on bran-name prescriptions filled in the coverage gap. 

This year, those falling into the doughnut hole will receive a $250 rebate.  No word yet on how it will be implemented but it’s welcome relief for Part D participants. 

Long-term Care – A government long-term care insurance program (referred to as CLASS- Community Living Assistance services and supports) was rolled into the bill and got little attention amidst the bigger issues. No details yet on how it will work or how much it will cost workers (it will generally be offered through employers and provides a minimal level of benefit ($50-$75 per day), but it gives hope to those who can’t qualify for long-term care insurance that there is a way to buy some protection against long-term care costs.  I’ll cover this more in a future post.  If you’re interested in reading more, this is a good summary from the American Association for Long-term Care Insurance (AALTCI)  

Over the next several weeks, I’ll be providing more information on what’s in the health care reform bill and how it impacts the sandwich generation. For baby boomers  planning for retirement, understanding health care costs in the future will be critical to figuring out how much money you’ll need.  A recent survey from Fidelity Investments says a 65-year-old couple today should have $250,000 socked away for health care costs in retirement –not counting long-term care costs.

 If there is something in the health care reform bill you’d particularlypleased about or would  like to hear more about, post it here.