Statements of Financial Responsibility

by Marc Manor

So, there you are at your pre-op appointment with your surgeon and you are asked to sign a “Statement of Financial Responsibility” or similar document.  This document is the “Cover Your Assets”/CYA insurance for the providers involved in the procedure.  Even the most minor surgeries can cost tens of thousands of dollars, so it is not surprising with the expense of healthcare these days, providers want some CYA.  I think they also do this to motivate patients to submit complete and current insurance information.  These acknowledgements are required by providers even if you have comprehensive healthcare coverage. Here are a few steps you can take to increase the chances your claims are properly processed.  

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Here are some things you can verify with your provider and insurance company to make sure you have the required coverage:

Tricare For Life and Medicare Advantage

By Marc Manor

Until very recently, I believed that retired military personnel using their Tricare For Life benefits would not have a need for Medicare Advantage plans; however, because of the numerous additional benefits available in many Medicare Advantage plans, I have come to realize that Medicare Advantage may bring additional value and healthcare options to my retired Veteran brothers and sisters when used in conjunction with Tricare For Life.

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First let’s talk about Tricare For Life.  Tricare For Life is a benefit earned by those career military personnel who are “retired” from the military.  It is considered “wrap-around” coverage for those retired military who have both Medicare Parts A and B.  While there is typically a monthly premium for Part B, there is no charge for the Tricare For Life wrap-around coverage for those who qualify.

While in many ways, Tricare For Life works similar to Medicare Supplement Plan F (the most comprehensive Medicare Supplement plans), yet it is different because one cannot use a Medicare Supplement plan in conjunction with Medicare Advantage (Medicare Part C).  Hence the term “wrap-around coverage”!  The reason this is so significant is because retired military members with Tricare For Life can use their benefit in conjunction with Medicare Advantage and therefore have three layers of Medicare insurance coverage!

Why have multiple layers of Medicare healthcare coverage you ask?

Avoiding the Medicare Penalty Box

by Marc Manor

Relative to most individual healthcare plans, many people find Medicare a significantly less expensive alternative with more coverage and lower deductibles.  After all, if you have been employed throughout your life, you have been paying into the Medicare system and have earned the Medicare Benefit!  If you have been employed for 10 years or more, it is likely your Medicare Part A will have no cost and your Medicare Part B will be only $135.50 per month* for most people (*Part B premiums are higher for higher income earners).   Medicare costs can be found here:  

https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance#collapse-4809

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To take full advantage of the value of your Medicare benefits, it is best to avoid late enrollment penalties.  There are late enrollment penalties for Medicare Part B and Part D and with so many low-cost options available, there are few reasons that would justify putting yourself in the Medicare “Penalty Box.”  Sometimes people seem surprised and are frustrated by the penalties.  They claim they just aren’t fair.  I understand how someone must feel but Medicare justifies these penalties because they base their rates and calculate their risk based on eligible beneficiaries in the pool of enrollees.  But you won’t care about why they penalize you for being late. So, let’s talk about the penalties and some ways you can stay within the rules and avoid them!

Seeking Healthcare Solutions Outside of Open Enrollment

by Marc Manor

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Navigating your way through an entire year with nothing to help you pay for medical bills can be a significant risk to your financial and personal wellbeing. Missing the Healthcare Marketplace Open Enrollment may not mean you have to go the rest of the year with no coverage at all. Many states have a variety of coverage options available that can help you fill the void if you are locked out of enrollment into an Affordable Care Act (ACA) compliant plan.

Saying to yourself that you are “healthy” and don’t need healthcare insurance can leave you thousands of dollars in debt so what choices do you have? Since options available in one state may be completely different than another, it's highly advisable to consult an independent healthcare insurance agent to help you get an objective opinion on your options. Here are a few possibilities:

Dear Politician: Just What Is “Medicare For All”?

By Marc Manor

As we prepare ourselves for the onslaught of political rhetoric associated with the 2020 presidential and Congressional campaigns, we have all heard the term “Medicare for All” as a means to fix our healthcare system.  I must admit, the more I hear the talk about Medicare for All, the more questions I have.  As an insurance agent who works to place Medicare beneficiaries into appropriate coverage, I can tell you that most people I talk to do not really understand our current Medicare system when they become eligible.  Based on much of what I have heard from politicians, it seems to me they also don’t understand Medicare.

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I should disclose, I do have some personal interest in how Medicare for All would come to be.  Obviously, if commercial insurance companies were cut out your proposed system, me and thousands (if not millions) of people would have to find a new livelihood.  Having said that, I would support any functional system of healthcare over what we have now for people not eligible for Medicare.

Recovering From a Medicare “Wrong Turn”

By Marc Manor

Much of what I do is problem solving.  Frequently, the problems relate to “wrong turns” through the streets of the Medicare “Metropolis”.  By wrong turns, I mean when someone that has been enrolled in Medicare Part A and Part B beyond their initial enrollment period finds themselves outside the traditional open or annual enrollment periods and wants to transition to or from Original Medicare.  Sometimes the constraints of the Medicare “system” prevent immediate relief. However, there are solutions in many cases depending on when and how the “wrong turns” occurred.

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Under the Medicare system, there are two basic paths: 1) Original Medicare and 2) Medicare Advantage (or Medicare Part C).  You can only be on one path or the other.  Typically, the path you choose occurs at the time you initially enroll fully into Medicare Parts A and B.  The choice initially of which path you take is very important so is necessary to give some basic information about these choices:

Employee Group Plans vs. Medicare; When to Cut the Cord.

by Marc Manor

If you are coming up on age 65 and you are still working and are using an employee group health insurance plan you may be asking yourself if you should dump the employer plan to take advantage of your Medicare benefits.  If you thought that, you are not alone.  This situation comes up frequently and as an agent, I can only really answer by making a recommendation that you seek assistance from your company benefits advisor.

Seeking assistance from your benefits advisor is really the only answer because they should be the most knowledgeable about the group plan benefits.  Human Resource professionals earn their living managing employee benefit plans.  So, as you ask yourself the question of whether to part ways with your employee group plan to join Medicare, you need to go to HR.  You may be fortunate and get the HR professional that provides you with all the information you need to make an informed decision; or you may just be handed a form and be left on your own to make the decision.

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Either way, you need to know the questions to ask just in case you aren’t presented with enough information to make a determination best suited for your situation.  Here are some tips: