Plan Advisors

Helping you choose the right health plan

Calculating the Medicare Part D Late Enrollment Penalty

ICEP

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Help your clients calculate the Medicare Part D late enrollment penaltyOne of the more common questions agents get asked from their Medicare clients is “what is the Medicare Part D late enrollment penalty?”  It is fairly easy to explain that if a Medicare member spends more than 63 consecutive days without having Part D or creditable drug coverage, they will be required to pay a late enrollment penalty should they choose to enroll in a Part D plan in the future.  The typical follow-up question is “will I have a late enrollment penalty?”  This is also usually pretty easy to answer, assuming the agent asks the proper questions of the client and the client responds with accurate answers about prior coverage.

[Read more…] about Calculating the Medicare Part D Late Enrollment Penalty

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Thirty three years ago when I started selling Medicare Supplement plans, in the back of my mind I knew someday I would be on Medicare myself.  What I did not know was the range of choices that would be available to me beyond traditional Medicare Supplement plans.
 
As I have indicated in the past my wife and I went onto Part A and enrolled in Part B of Medicare this year.  I started on May 1st and my wife February 1st.   Just some background, the past eight years I have had a high deductible plan with Life Wise of Washington state.  We had a $6000 family deductible plan and was paying about $700 per month the last year we had the plan.  I had also enrolled in an HSA eight years ago as well so today the balance of my HSA account is over $50,000.  As most of you know this fund can be used for co-pays for doctors visits as well as prescription drugs.  
 
My wife and I both chose the $0 premium MA only PFFS plan available in Washington state. (My wife does take some prescription drugs so I enrolled her in Humana’s WalMart standalone PDP, as I do not take any drugs, I chose not to enroll in a PDP.)  This is a Medicare look alike plan meaning I am responsible for the Part A hospital deductible and 20% of the Part B outpatient expenses, however, there is no Part B deductible, I pay 20% from the first dollar of charges.
 
I have used this plan three times so far, twice at the ophthalmologists and once at the dermatologists.  I could not be happier with how the plan works.  First of all, I am not paying for my healthcare in advance in the form of a premium.  Not for a high deductible plan like I did before going onto Medicare or for a traditional Medicare supplement.  I am only paying for 20% of the Medicare approved charge and that is a lot less the than the $8400 in premium I paid for Pat and I last year.  If I had chosen a traditional Plan F my premium would have been around $200 per month for me and $200 for Pat or about $4800 per year.  
 
I have my annual physical scheduled for the fist week of August with the doctor I have had the past several years.  In past her office accepted Life Wise.  Before going onto Medicare I called my doctors office to explain I was planning on enrolling in Humana’s MA only PFFS plan.  The office manager explained they did not officially accept Humana but as I was currently a patient, the office would accept Humana’s terms and conditions and bill them directly so I could continue to keep my current doctor.
 
So far I could not be happier with the choices I have made.  I now go to the downtown YMCA using Silver Sneakers and no longer pay $55 per month to OZ fitness.  The best part is on October 15th I can look at all the options available for 2014 and make a new choice if I find a better option with no pre-existing conditions or waiting periods.  The new choices today really are a win win situation for Medicare beneficiaries like me. 

[Read more…] about Larry affirms his Medicare Health plan selection two months later

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Larry Bishop has enrolled in a Humana Medicare Advantage Plan

You have been kind enough to receive emails from me for the last seven years about Humana’s Medicare Advantage plans. Today I would like to share my personal experience from yesterday with enrolling into a Humana plan.

[Read more…] about Officially a Humana MAPD Member

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Larry Bishop turns 65 and enjoys the benefits of MedicareMany of you may know that this year will be a milestone birthday for me. I turn 65 in May! In the past I never associated Medicare benefits with my own personal circumstances, but now it’s become something I think about frequently. I’d like to share some of the experiences I’ve had recently, and hope you find it insightful as you grow your business and interact with folks like me for years to come.

[Read more…] about After 33 Years in the Business, it’s My Turn!

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As you know, selecting the correct election period for your client when facilitating an MAPD enrollment is an important step toward ensuring the beneficiary’s enrollment form is processed for their proposed effective date. For 2013, there is a change in guidance of when to use IEP vs. ICEP. Let’s take a closer look…

[Read more…] about New rules regarding when to use the IEP vs ICEP election code