Paid Advertisement Ask the Medicare Specialist by: Aaron Zolbrod Welcome to Part 6 of the series, "New to Medicare," which I'm writing to help those who will be going on Medicare Part A, B, or both for the first time in the near future. QUESTION: What are the most important considerations when choosing a Supplement as well as a Part D prescription plan and what and plans and companies are the best? ANSWER: Common thinking is. "If rates go up, I'll just move to another company or plan." Unfortunately it's not that simple with Supplements like it is with Advantage Plan HMO's or PPO's, who must accept everyone who Medicare Assignment are able to do that. There are almost zero specialists, and not one full service medical hospital in the country that doesn't accept Medicare Assignment. Out of the thousands of clients we've enrolled in Plan N since 2010, not once have we heard from anyone who was billed Excess Charges, According to the Centers for Medicare and Medicaid, "All Medigap policies must follow federal and state laws designed to protect you, and policles must be clearly identified as Medicare Supplement Insurance. Each standardized Medigap policy must has Medicare Parts A and B. offer the same basic benefits, no matter which insurance company meaning your medical history sells it. Cost is usually the only difference between Medigap policies with the same letter sold by ifferent insurance companies." physicals when applying, a very Let me start by explaining there are only 11 Suppleiment plans those they do is ask a series of medical on Medicare Parts A and Bean choose from, nine for those who turned 65 on or after January Ist, 2000. They are A,B,D.G.K.L.M,N. and high deductible G. Plans Fand 0ne's answers to the questions, C were eliminated for sale because companies determine who they they are a rip off, a description I give for lack of space to explain it This means there will be people more tactfully The bottom line is this. Every Supplement plan ocovers the same exact medical services and grants access to the exact same Supplements are underwritten, is taken into account and your application for coverage can be denied. Companies don't require Regarding Part D, there really is no plan or company that's "best" for everyone. What Part D plan is most cost effective is almost 100% determined by what medications one is taking at the time they go on Part B. Part Dalso needs to be reviewed every single year, which we do for all our Supplement clients. Even if one's medications and premiums haven't changed this is a must because drugs that were covered one year can be taken off formulary the next. Drug tiers can also change, resulting in higher co-pays. Insulin dependent diabetics risk missing out on thousands of dollars in savings if they buy a plan that doesn't doctors and hospitals nationwide. Oonditions are either stuck paying include the new "Part D Senior common misconception. What questions and review one's Medical Information Bureau, the medical history equivaknt of a credit report. Based on it, and accept and decline. who won't be able to move to companies or plans that offer lower premiums, And there will almost certainly be a time when those with certain medical more money to remain on a Supplement or will be forced to move to an Advantage Plan that can expose them to as muchas $7,550 in medical bills each year as well as limit what doctors and Savings Program." and providers don't even bill Supplement companies. They bill Medicare, who then coordinates with the company to pay their share of the claim. Supplement companies also have no say in Paying S00 or $00 more a year for Part D "just in case," of what one might be prescribed later in the year, or a plan that doesn't have a deductible is also a common what's covered. That's Medicare's hospitals they can use. HMO's and mistake. In addition, higher PPÓ's are good options for many, but not everyone. determination alone, which means no prior authorizations are necessary and doctor's call the shots, not an insurance company Therefore, it makes no difference to the doctor or hospital abouat 95% of the time. Again, the what Supplement company their patients have. 1 stimate there are 100 or more who sell Supplements. Currently we send 99% of our Supplement business to just three. Two of those have the lowest available prices in Western PA, which is our choosing Plan Ncould result in first criterion when considering who we are going to place clients with. Next is what their history of rate increases are. All three we use have an excellent reputation of alue. This will be especially true keeping those to a minimum over the years. We can get appointed to sell plans with almost any Supplement company however l'm very leery of doing businesS with new ones out of fear they may start out competitive, then employ more frequent and larger premium increases, something we see often. priced plans do not eliminate the Donut Hole. All Part D plans, regardless of monthly premium, have regulations designed to protect the consumer. Those who get prescribed medications that aren't on their plan's formulary must be given what is known as an emergency transitional 30day supply This gives him or her time to get with their doctor to prescribe an alternative drug or to file for an exception to the formulary We help our clients navigate through all of this in the event they find themselves in these situations. We also have a Prescription Drug Caseworker, Tony DiRoma, who works one on one with any client who is in danger of falling into the Donut Hole and/or paying exorbitant costs for medications. As far as what plans are the best, we advise our dients to choose between Gand N. I recommend N company selling the plan doesn't matter due to all the regulations. Many people are skeptical of N for two reasons, both of which they need not be. My experience is that Fand G have been labeled "the best" and in peoples' minds, thousands of out of pocket costs. That's simply not the case. When premium savings are factored in. Nis almost always the better in five to ten years when I predict premiums on G will be $700 to $1,200 more per year than N, and $1,400 to $2,500 more per year for E Some also worry about "Excess Charges" that are covered by Fand any other column or to schedule G, but not N. Again, not a concern. an appointment for a no cost First, it's illegal to bill excess charges in Pennsylvania. Secondly email me personally at only doctors who don't a With questions regarding this or consultation, give us a call or taccept aaron@getyourbestplan.com. 724-603-3403 The Health Insurance Store.e Connellsville 412-349-8818 Forest Hills Email your question to: aaron@getyourbestplan.com www.getyourbestplan.com No-cost, unbiased Medicare plan review and consultation with local, licensed agents Paid Advertisement Ask the Medicare Specialist by: Aaron Zolbrod Welcome to Part 6 of the series, "New to Medicare," which I'm writing to help those who will be going on Medicare Part A, B, or both for the first time in the near future. QUESTION: What are the most important considerations when choosing a Supplement as well as a Part D prescription plan and what and plans and companies are the best? ANSWER: Common thinking is. "If rates go up, I'll just move to another company or plan." Unfortunately it's not that simple with Supplements like it is with Advantage Plan HMO's or PPO's, who must accept everyone who Medicare Assignment are able to do that. There are almost zero specialists, and not one full service medical hospital in the country that doesn't accept Medicare Assignment. Out of the thousands of clients we've enrolled in Plan N since 2010, not once have we heard from anyone who was billed Excess Charges, According to the Centers for Medicare and Medicaid, "All Medigap policies must follow federal and state laws designed to protect you, and policles must be clearly identified as Medicare Supplement Insurance. Each standardized Medigap policy must has Medicare Parts A and B. offer the same basic benefits, no matter which insurance company meaning your medical history sells it. Cost is usually the only difference between Medigap policies with the same letter sold by ifferent insurance companies." physicals when applying, a very Let me start by explaining there are only 11 Suppleiment plans those they do is ask a series of medical on Medicare Parts A and Bean choose from, nine for those who turned 65 on or after January Ist, 2000. They are A,B,D.G.K.L.M,N. and high deductible G. Plans Fand 0ne's answers to the questions, C were eliminated for sale because companies determine who they they are a rip off, a description I give for lack of space to explain it This means there will be people more tactfully The bottom line is this. Every Supplement plan ocovers the same exact medical services and grants access to the exact same Supplements are underwritten, is taken into account and your application for coverage can be denied. Companies don't require Regarding Part D, there really is no plan or company that's "best" for everyone. What Part D plan is most cost effective is almost 100% determined by what medications one is taking at the time they go on Part B. Part Dalso needs to be reviewed every single year, which we do for all our Supplement clients. Even if one's medications and premiums haven't changed this is a must because drugs that were covered one year can be taken off formulary the next. Drug tiers can also change, resulting in higher co-pays. Insulin dependent diabetics risk missing out on thousands of dollars in savings if they buy a plan that doesn't doctors and hospitals nationwide. Oonditions are either stuck paying include the new "Part D Senior common misconception. What questions and review one's Medical Information Bureau, the medical history equivaknt of a credit report. Based on it, and accept and decline. who won't be able to move to companies or plans that offer lower premiums, And there will almost certainly be a time when those with certain medical more money to remain on a Supplement or will be forced to move to an Advantage Plan that can expose them to as muchas $7,550 in medical bills each year as well as limit what doctors and Savings Program." and providers don't even bill Supplement companies. They bill Medicare, who then coordinates with the company to pay their share of the claim. Supplement companies also have no say in Paying S00 or $00 more a year for Part D "just in case," of what one might be prescribed later in the year, or a plan that doesn't have a deductible is also a common what's covered. That's Medicare's hospitals they can use. HMO's and mistake. In addition, higher PPÓ's are good options for many, but not everyone. determination alone, which means no prior authorizations are necessary and doctor's call the shots, not an insurance company Therefore, it makes no difference to the doctor or hospital abouat 95% of the time. Again, the what Supplement company their patients have. 1 stimate there are 100 or more who sell Supplements. Currently we send 99% of our Supplement business to just three. Two of those have the lowest available prices in Western PA, which is our choosing Plan Ncould result in first criterion when considering who we are going to place clients with. Next is what their history of rate increases are. All three we use have an excellent reputation of alue. This will be especially true keeping those to a minimum over the years. We can get appointed to sell plans with almost any Supplement company however l'm very leery of doing businesS with new ones out of fear they may start out competitive, then employ more frequent and larger premium increases, something we see often. priced plans do not eliminate the Donut Hole. All Part D plans, regardless of monthly premium, have regulations designed to protect the consumer. Those who get prescribed medications that aren't on their plan's formulary must be given what is known as an emergency transitional 30day supply This gives him or her time to get with their doctor to prescribe an alternative drug or to file for an exception to the formulary We help our clients navigate through all of this in the event they find themselves in these situations. We also have a Prescription Drug Caseworker, Tony DiRoma, who works one on one with any client who is in danger of falling into the Donut Hole and/or paying exorbitant costs for medications. As far as what plans are the best, we advise our dients to choose between Gand N. I recommend N company selling the plan doesn't matter due to all the regulations. Many people are skeptical of N for two reasons, both of which they need not be. My experience is that Fand G have been labeled "the best" and in peoples' minds, thousands of out of pocket costs. That's simply not the case. When premium savings are factored in. Nis almost always the better in five to ten years when I predict premiums on G will be $700 to $1,200 more per year than N, and $1,400 to $2,500 more per year for E Some also worry about "Excess Charges" that are covered by Fand any other column or to schedule G, but not N. Again, not a concern. an appointment for a no cost First, it's illegal to bill excess charges in Pennsylvania. Secondly email me personally at only doctors who don't a With questions regarding this or consultation, give us a call or taccept aaron@getyourbestplan.com. 724-603-3403 The Health Insurance Store.e Connellsville 412-349-8818 Forest Hills Email your question to: aaron@getyourbestplan.com www.getyourbestplan.com No-cost, unbiased Medicare plan review and consultation with local, licensed agents