When you become eligible for Medicare, you’ll have to make some very important decisions. Taking the time to shop around for plans can save you a lot of money on prescription drugs and other healthcare expenses. However, it’s easy to get caught up in complicated terms, misconceptions, and marketing material. If all the complexities of Medicare have you scratching your head, don’t worry! Here are some quick tips to help you make the right choice.

 

Learn About Your Options

People signing up for Medicare have two basic options for coverage: Original Medicare or a Medicare Advantage plan. If you go with Original Medicare, you can add prescription drug coverage and/or supplement with a Medigap plan to reduce your out-of-pocket expenses. Alternatively, most Medicare Advantage plans include dental, vision, and hearing coverage and offer services not covered by Original Medicare.

There are several online resources that can help you understand Medicare a little better. For example, it’s a good idea to look for information on the sign-up process before enrolling, especially if you’re not very tech-savvy. Medicare.org details everything you need to know about signing up for a Medicare Advantage plan. As you navigate the maze of Medicare, use resources like these if you ever need help.

 

Be Aware of Medicare Myths

One of the most common myths surrounding Medicare is that the program is free. Original Medicare, the federal government program, is broken into Part A and Part B. It’s true that Part A is free for most Americans, but Part B requires a monthly premium. On top of this, you will face costs for deductibles and copayments with Original Medicare.

Many people also think that Medicare covers all areas of healthcare. While Original Medicare does cover many expenses, which you can read about here, it does not cover everything. For example, Medicare does not pay for hearing, dental, or vision care. You will also have to pay for an additional plan — called Medicare Part D — if you want prescription drug coverage.

 

 Make a List of Your Healthcare Criteria

Many seniors choose to supplement Medicare with a Medigap or Medicare Advantage plan. Read this for help understanding the difference between the two. Original Medicare with a supplementary Medigap plan may give you more flexibility regarding which healthcare providers you can visit. On the other hand, Medicare Advantage plans usually include a wider range of benefits. Many Medicare Advantage plans cover preventive services and wellness programs. According to Forbes, this may encourage seniors to follow a healthier lifestyle.

Compare Medicare plans against a list of your personal criteria for help picking out a plan that’s well-suited to your needs. Note any specialists you visit, such as chiropractors, physical therapists, or acupuncturists. If you have preferred local doctors, pharmacists, or hospitals, include these on your list as well. It’s a good idea to talk to your doctor about any upcoming medical needs that you may need to have covered in the future. Also, you can use this guide from Kiplinger to find a Medicare drug plan that will cover your medications and dosages. As you’re comparing plans, don’t forget to look at the premiums and co-payments associated with each. Plans with lower premiums usually require higher co-payments and vice versa.

 

Be Cautious to Avoid Scams

As you shop around for coverage, be alert to common Medicare scams. In general, an unsolicited caller claiming to be an “official Medicare agent” is likely a scammer. These people may threaten seniors with penalties or offer deals to sign up for their special plan. Remember, the government will never call you about your healthcare coverage! While there are many reputable, licensed insurance agents selling Medicare plans, they cannot contact you in any way without your permission — this includes cold calling, leaving flyers, and visiting your home.

Choosing the right Medicare plan will lay the groundwork for your future health. Shop around, compare plans, and make an educated decision. A great plan that meets your personal criteria and covers valuable services will help you prevent health problems and maintain your general wellness as you embark into retirement.

 

Guest post by Karen Weeks: Karen created Elder Wellness as a resource for seniors who wish to keep their minds, bodies, and spirits well. 

Photo via Unsplash

Would you appreciate the stability of having the same health insurance plan for up to three years? Do you want coverage for preventive care, office visits and prescriptions but need a more affordable option than what has been available up to this point?

There have been some exciting developments in the past year when it comes to private health insurance plans. Insurance companies continue to offer low-cost health plans that cover only the Essentials – injuries, illnesses, and sickness – but the loosening of restrictions has helped matters. Insurers have responded by offering benefits, calling these new plans Enhanced.

How, exactly, are they enhanced? Insurers now have plans that offer:

  • More copay benefits.
  • Greater preventive care benefits.
  • Tiered prescription benefits.
  • Guaranteed renewal for up to 3 years instead of 1.

*Enhanced plans are not available in all states.

**Enhanced plans are being offered by Golden Rule (United Healthcare PPO) and National General (Aetna & Cigna PPOs).

Call the Rhoads Insurance Agency today to learn more.

The HealthiestYou telehealth app from Teladoc® has always offered individuals and families access to 24/7 virtual care from a nationwide network of doctors – all for the cost of a small monthly membership fee. Beginning October 1, 2019, for an additional per-use charge, that access will extend to Behavioral Health Care and Dermatology Services.

NEW! Behavioral Health Care – Your clients can receive support for anxiety, depression, eating disorders, family problems, and other issues. Care from a licensed psychiatrist, psychologist, or therapist is available by phone or video 7 days a week.

NEW! Dermatology Services – Your clients can share photos of their skin condition or infection with a board-certified dermatologist and receive a diagnosis and treatment plan within two business days (typically within 8 hours).2 Free follow-up is included for a week after the session.

Included with Membership – Your clients will still have access to doctors ready to diagnose, treat, and prescribe medication for many of the most common ailments, right over the phone. They can use the app to find a doctor, dentist or other provider in their area, and comparison shop to get the best price on a procedure or prescription.

HealthiestYou can be a great add-on to insurance products! Call us today to add coverage.

Are you confused by Life Insurance? Can’t decide which plan to go with? Or maybe you think you just don’t need it? Well here’s a Hint: You’re thinking about it all wrong.

As an agent, I actually get angry when I hear about people who have children, but they have no, or very little, life insurance. I’m angry at the person, I’m judging them hardcore, and I think:

“You’re a #$!# adult, with people depending on you, and you don’t have the $&%# sense to make sure that if you die they’ll be okay?! You work your butt off, you work that way to provide for them. So if you’re not there to provide for them, then what happens to them?”

It makes me angry that people learn things the hard way, when they don’t have to. They get a mortgage, take care of their family, and think that they don’t need life insurance. Then, one day, something happens – they die, or can’t work anymore, or have out-of-control medical bills. These people come to me and ask for help, when it’s too late. Their only resort then is a damn GoFundMe campaign!!

And don’t over-complicate it. If you die, do you know what the ONLY question your spouse will ask your insurance agent is? Your spouse won’t ask whether it is Term or Permanent Life Insurance. The only question they will ask is, “How much is it?”

As an agent, I don’t even care whether you get the life insurance with me or not. If you’re not asking this simple question, “Do I have enough Life Insurance,” then you’re setting your family up for financial loss.

Many Americans could not afford an unexpected $1,000+ medical bill, and deductibles are often even higher than that. So just imagine needing $10,000 a month for chemo, or needing open heart surgery! That’s what happens if you’re diagnosed with cancer, heart attack, or other critical illness. You may need help with your deductible.

A critical illness (CI) insurance policy can fill that gap in coverage and keep you afloat. CI pays you a lump sum that you can use however you like – to pay what your health insurance didn’t cover, or to pay household bills while you take time off work to recover.

 

Did you know that there are 2 ways to get CI coverage?

Stand-alone CI policies larger than $50,000 are not avaiable though. That would help with deductibles.

Another, better way to get CI benefits is to get life insurance with living benefits. Living benefits bundles critical illness benefits together with chronic and terminal illness benefits, into a life insurance policy. This isn’t available with all life insurance policies, so talk to your agent about it.

With this type of policy, you can convert 75-95% of your life insurance’s death benefit into something you can receive while you’re still living.

If you need life insurance, this is a much more economical way to plan your benefits. Call us to learn more.

Vision insurance easily gets overlooked. It’s about the least expensive type of insurance that exists — and maybe you can do without a new pair of glasses this year, right? So it’s okay to ignore or push off to next year, am I right?

We disagree. Vision insurance will make a big impact on your appearance and lifestyle. And all for just a few dollars a month. Consider the following:

  • Seeing clearly will ensure you’re productive and successful in your work life and your home life.
  • Glasses need to be replaced from time to time, just due to normal wear and tear.
  • You feel better about yourself when you buy nice-looking new clothes. It’s the same when you get new glasses. You feel good and look great.
  • Vision benefits can be used every calendar year. But most plans offer so much savings that you’re still saving if you only get a new pair of glasses every 24 months!

So don’t put off getting new glasses, and don’t pay full retail price.

Does Medicare Cover Travel Abroad?

The Center for Medicare Services (CMS) has this to say about travel:

Medicare usually doesn’t cover health care while you’re traveling outside the u.s. There are some exceptions, including some cases where Medicare Part B (Medical Insurance) may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S.

Medicare drug plans don’t cover prescription drugs you buy outside the U.S.

 

So where can I find travel insurance?

We at the Rhoads Agency don’t focus on international insurance plans, but we do offer them. They are so versatile and affordable, that we think that everyone should have one when abroad. We work with International Medical Group (IMG) plans, that cover evacuations and medical care. Their plans also help ease trip cancellations and lost luggage.

There are plans for business travelers, globe-trotting seniors, missionaries, marine crew, and exchange students, as well as foreign nationals visiting the U.S. And plans can be customized to last anywhere from 5 days to 2 years, depending on your plans.

If you’re a retiree looking to visit Europe, go on a cruise, or have other international plans, give us a call!

 

New Prescription Product

Prescription medications can be expensive. But until now, the Rhoads Insurance Agency has been unable to offer anything for individuals and families. Now we have a solution. We recently contracted with the IHC Group to be able to offer the RxPay Advance Drug Card.

 

Why Haven’t We Had Options Before?

Prescriptions are an uninsurable risk, except for older consumers who are much more likely to need prescriptions as a demographic. For the rest of us, we only want protection from high prescription costs when we’re sick. So most of us would choose not to have prescription coverage.

The insurance companies would lose too much money, unless everyone got it and not just the sick.

There are exceptions, such as when the government forces companies to include prescription benefits. This is the case for the ACA Marketplace. Another exception is for Group insurance, when everyone at a company is required to join the plan whether they need it or not.

 

Most Private Plans offer only Discounts

Discount plans usually don’t work. We’ve tried a lot out and have been underwhelmed. The best situation you’ll be able to find are plans that reimburse you a fixed amount, for up to 12 pharmacy visits per year. Those benefits help, but there are many cases where the reimbursement amount is miniscule compared to the cost of, say, a specialty brand name drug.

 

How does this RxPay Plan work?

No prescription plan has to cover all medications. Instead, each plan establishes a formulary – a list of medications that are covered under the plan. Formularies are established with input from doctors, pharmacists, and administrators.

The Advance Drug Card focuses on generic and other low cost brand name drugs. This program is designed to help you find drugs within the same therapeutic class as a drug you may currently be taking. Most of all, this program is designed to save you money on your prescription drug costs.

Tiers indicate retail pharmacy pricing and position. Drug quantities listed must be adhered to in order to receive tier pricing at participating retail network pharmacies.

 

Contact Us for More Details

Want to get a quote and enroll in the RxPay Advance Drug Card? Set an appointment with us here:

Request a Free Quote

Trends in Group Coverage

Many people I speak with still hold employer-provided Group plans as the best kind of health insurance. Trends in group coverage actually suggest otherwise. This point of view is expressed in an article on the Harvard Business Review recently:

As a result of these trends, employers have shifted costs to employees; one common example is the implementation of high-deductible insurance plans, which increase consumers’ out-of-pocket costs. High costs can hurt employees in other ways, too: there’s evidence that as employer-provided health costs rise, employers are constrained in their ability to increase wages.

Consumers will see with their employer-provided insurance plans, all things being equal, that deductibles will rise, and they will have to pay more out-of-pocket for healthcare. I’m not about to suggest you turn down your employee health insurance plan though. Your employer is paying for most of it. But it will cover less in the future.

What to do then, if you’re in this situation? I’d suggest you get a hospital and doctor plan to go with your employer coverage. That could help pay all or part for doctor and outpatient healthcare expenses, before your deductible is met. That would be the best way to manage your healthcare costs.

Talk to me today and I’ll explain how we could help.

Dan Rhoads

ACA premiums rising beyond reach of older, middle-class consumers

Sixty-year-olds with a $50,000 income must pay at least one-fifth of what they earn for the least expensive premiums for health plans in Affordable Care Act marketplaces across a broad swath of the Midwest, the analysis shows. In much of the country, those premiums require at least one-sixth of such people’s income.

And that’s just the beginning. I’ve seen plans as high as $4400/month! Obamacare is too expensive.

So what do you do? Well, let me give you my perspective.

Yes, there should be options that cover pre-existing conditions, and I’m concerned for uninsured people out there who will be caught in the trap should the ACA become unsustainable.

But, THERE ARE ALTERNATIVES. Talk to me. Get health insurance BEFORE your health takes a turn for the worst.

I have plans and options that are affordable and can stay with you until you turn 65 and get Medicare.