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

Courtesy of canva.com

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

Courtesy of pexels.com 

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.

Courtesy of pexels.com

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.

Courtesy of pexels.com

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:

Changing your Medicare Plan - Should I Stay or Should I Go?

by Marc Manor

For a number of reasons you may be asking yourself if you should make a change to your Medicare Insurance or Prescription Drug Plan.  I am often asked, “what do you think about this company” or “which company is best”?  Because of Centers for Medicare and Medicaid Services (CMS) regulations, I am not allowed to impart my personal opinion in answering these types of questions.  Agents are only allowed to state the facts when it comes these questions and besides, the question should be which plan is best for you in your situation based on your doctors, ongoing medical concerns, and the prescription drugs you are currently taking.  When it comes to Medicare Insurance Plan performance, it’s all in the stars!

Courtesy of pexels.com

Each Medicare Advantage (Part C) and Prescription Drug Plan (Part D) are assigned a star rating by CMS each year.  That is the objective criteria we as agents can use to let you know how that company performs.  The star ratings are assigned using a system of surveys that are compiled using information that is obtained from providers and members, among others.  But star ratings alone are not the only indicator of whether you should make a change or not.  Here are some things to think about before making a change:

What does $9.95 buy in 2019?

By Marc Manor

I was thinking of what I subject I should tackle on this blog and just like a gift from

heaven above, it fell right into my lap.  The TV was on and I heard a familiar celebrity

making a pitch for Life Insurance. His contention was that “price” was the most

important aspect of this guaranteed issue Life Insurance product for which you

“could not be turned down.”  Every example he gave came with a monthly premium

of only $9.95.

Courtesy of pexels.com

I thought this would be a good subject

because, I have had many people trying

to get Life Insurance to cover final

expenses and they are shocked when

I tell them what their monthly premium

would be for $10,000 to $20,000 of

insurance.  Some will say, “I think I’ll

look elsewhere. Mr. Celebrity said

I could get insured for only $9.95”. So, I

decided to run a quote on their website

to see what $9.95 would buy me (using

my age and zip code) to protect my

family in the event of my demise:

$1,214.00 of insurance!  Yes, I would

only have to pay $9.95 but how far would

that $1,214 go?

Let’s take a look at average funeral expenses

according to the National Funeral Directors Association (NFDA) for 2017: