Posts tagged with "independent insurance broker"

Medicare and ObamaCare (Individual and Family) Annual Open Enrollment

Are you overwhelmed with the ads on TV about your health insurance plan options?  Is your table piling up with mail from every insurance company and agent?  The reason is, it’s Open Enrollment time for Medicare and Individual/Family (affectionately known as ObamaCare).  This is the period where you can switch plans or enroll into a new Part C (Medicare Advantage Plan) and Part D (Part D Plan) OR individual/family health insurance plan.  Here are the dates:

MEDICARE – October 15th – December 7th

INDIVIDUAL/FAMILY – CA, October 15th – January 15th (depending on your State – some are from Nov 1st – Dec 15th)

What to look for?  All plans seem to change something, especially the drug formulary (the list of medications they cover and which Tier they’re covered on). Look at your ANOC (Annual Notice of Change) booklet that you recently received (or call your Plan if you haven’t received it yet).  The first few pages will tell you what is changing in your Plan for the next year. There are also new Plans that are created each year and research needs to be done to see if there is another Plan that may offer you better benefits.   Many Medicare Advantage Plans offer extra benefits like chiropractic, acupuncture, vision, hearing, dental or gym memberships.  If you feel your Plan is good for you next year, there is nothing to do.  It will simply roll over.

Look for the ‘Star Ratings’ of the Medicare Plans also.  Medicare gives an overall rating of the Plan’s quality and performance for the types of services each plan offers.  For plans covering health services, this is an overall rating for the quality of many medical/health care services that fall into 4 and 5 different categories.  From my experience, there is a reason a Plan gets a low rating so BEWARE!                                         

Medicare uses a 5 Star Rating

This is also the time for those that are uninsurable (maybe in a nursing home or just diagnosed with cancer, etc.) to possibly obtain ‘guaranteed issue‘ into a MediGap supplement plan. If ANY benefit in your Medicare Advantage Plan increased by 15% or was eliminated, a window opens for you to go back to original Medicare (Part A & B) and obtain a MediGap Supplement (with NO insurable questions asked) and a stand alone Part D Plan (for drugs).   With this option, it gives you the choice to see ANY Provider that accepts Medicare, no referral needed!  It comes in handy if you want to go to a skilled nursing facility of your choice or have a surgery from a particular Surgeon.  

If your loved ones or neighbors are on Medicare, please help them.  Many times, they stay on the same Plan because they just don’t know who to turn to.  You can make a huge difference in their lives by having them to call us!

So what’s a person to do?  You can do your own research by going to Medicare.gov/Healthcare.gov OR reach out to an independent insurance broker/agent such as ourselves.  Imagine if you could put your head on your pillow tonight, knowing all this was behind you and you knew you made the right choice!  That’s what WE do for you!  We conduct a thorough search and will let you know if your Plan is right one or if you should look at other options.  The icing on the cake…there is no extra charge for our services!  How do we get paid?  If another Plan is better and we’re able to enroll you, we receive a commission from the insurance company.   If you’re on the best plan, we’ll let you know that too!  Make sure the person you are working with is REALLY independent and represents MANY companies.  We have come across many agents that are independent, however they are only Medicare certified with one or two companies :/   At Hoffman Insurance Resources, we are contracted with over 40 companies and Medicare certified with 13 carriers.  YOU’RE best interest is our interest, whether we get compensated or not.  If that wasn’t enough, we’re here for you AFTER we enroll your plan.  We’re your advocate and can help with everything from getting another ID card to helping with a bill you don’t understand.  Check out our Yelp and Google reviews.  Our clients are amazing and very giving  of their stories.  We’re sure one or two will resonate with your situation.  Your only assignment is to reach out to us early because it gets quite busy during the last week of Open Enrollment and our time is extremely limited.  Looking forward to hearing from you!

Hoffman Insurance Resources is an independent insurance brokerage agency specializing in Medicare and individual/family health plans.  We are contracted with over 40 companies, Covered CA certified and Medicare certified with 13 carriers.  Physically located in the Los Angeles area, we are also contracted in many states throughout the country.  We pride ourselves on doing what’s right for our clients (whether we make money or not), educating you, being your advocate after the sale and exceeding your expectations. We accept only the insurance company commissions so there are NO extra charges for our assistance and guidance.  From ObamaCare through MediCare…we truly Care!  Check out our reviews on Yelp and Google 🙂

Debbie@Go2HIR.com      323.455.4961      www.Go2HIR.com    https://www.facebook.com/hoffmaninsuranceresources

 

medicare

Avoiding Medicare Part B Penalty, Part 1 – Medicare Eligible and Covered Under an Employer Group Plan

Welcome and thank you for reading my very first blog!  I’m extremely honored and grateful you chose to spend a few minutes of your time with me.   My goal is to bring something valuable to your life that will put you in a better health and wealth position AND make confusing subjects, easier to understand.  One of the most disheartening parts of our job as an independent insurance agent is to give bad news to a client and not being able to do anything about it.  From our vast experience, I’d like to use this blog to help you avoid some of the ‘gotchas’, pitfalls and crazy rules that could get you in a pickle later.    

If you hadn’t noticed, Medicare can be very confusing.  There are some really quirky rules in Medicare and this is one of the craziest.  It’s relatively easy to enroll into Medicare when you turn 65 and your situation is pretty straight forward.  However, if you have something out of the ordinary, you need to know the rules so you won’t get penalized in the future.  This has popped up a few times in my career so it’s good to realize it’s a problem in case you know of anyone that fits the situation. You don’t have to know ALL the rules, you just have to be aware it could be a problem and know where to seek guidance.  Unfortunately, many of Social Security’s own staff do not understand this rule.  It has to do when do you apply for Part B if you are covered under an employer group plan.  The rule (from Medicare.gov) is you can delay Part B (and avoid the penalty) if:

  • You have insurance through an employer or union.
  • You or your spouse (or family member if you’re disabled) are still working.

Notice the 2nd part of the rule…’still working‘.  That’s the part most people miss.  But wait…there’s more!  In addition to being penalized, you cannot apply for Part B at just anytime of the year unless you have a ‘special circumstance’.  This situation does NOT fall under one of their ‘special circumstances’ and therefore you can ONLY apply during the Part B Open Enrollment which is from January 1 – March 31st.  But wait…there’s even more!!  Your Part B won’t become effective until July 1st!

Here are a couple of stories that illustrate the problem:

  1.  Betty retires at age 60, her spouse, Bob, is 65.  Part of her School District’s contract with the union covers her for insurance till she turns 65.  That’s normally a great benefit, UNLESS your spouse is eligible for Medicare!  In this case, Bob delays Part B because he is still covered under the group plan.  When she turns 65, they both go into their local Social Security to apply for Part B where they are informed Bob will have to pay a penalty because he did NOT obtain Part B when she ‘stopped working’. The Part B penalty is 10% for each year he didn’t have the Part B = 50% of the current Part B premium!  For 2017, the Part B premium is $134, therefore, he pays an additional $67/month…FOREVER!  AND it will increase as the Part B premiums increase.

AVOIDING THE PENALTY:  When Betty retired at age 60, Bob should have applied for his Part B at that time. 

  1. Susan, age 64, has an accident at work and goes onto worker’s compensation.  When she turns 65 (even though she isn’t technically working), her company continues to keep her on the employer group plan.  At that time, she goes to her local Social Security office where she meets with an agent and is upfront, informing the agent that she is out on disability but still covered under her group plan.  The Social Security agent tells her that she can delay her Part B.  After 2 years of being on disability, the employer group plan stops.  She goes back to the Social Security office and they inform her that she will be penalized 20% for 2 years of not having Part B when she was eligible.  The good news is she kept VERY good notes, recorded the date/time and name of the agent.  This is IMPORTANT because everything is video recorded at the SS office and they can look back at the recordings to verify her story.  Because it was a Social Security agent that misinformed her, she is currently appealing through Medicare (we’ll discuss appeals in another blog).  My thought is she will have the penalty reversed because she kept good notes and SS misinformed her.

AVOIDING THE PENALTY:  When Betty turned age 65, she should have applied for his Part B at that time. 

So think about it, if Bob or Susan tried to apply for their Part B on April 1st, they have to wait till January 1st of the NEXT year AND they won’t have coverage till July 1st of the NEXT year.  Yikes!  That means they will have to go without doctor/out patient medical coverage for 1 year and 3 months or have to purchase an individual plan at exorbitant rates because they are over age 65 (ESPECIALLY during ObamaCare).   In my opinion, this is insane and should be changed!

In summary, keep excellent notes when you speak with Social Security or Medicare.  Record the date, time and everyone’s name you speak with!   I also suggest asking different agents the same question to see if their answers coincide.  If possible, obtain something in writing.  AND hold onto to that info FOREVER!

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#collapse-3156

 

Debbie Hoffman is an independent insurance broker specializing in Medicare and individual/family health plans, contracted with over 40 companies and Medicare certified with 13 carriers.  Located in the Los Angeles area, she is contracted in many states throughout the country.  She prides herself on educating her clients, being their advocate and exceeding their expectations.  She accepts only the insurance company commissions so there are no extra charges for her assistance and guidance.  From ObamaCare through MediCare…Debbie cares.

debbie@debbiehoffman.com    323.455.4961