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It’s That Time of Year – September is Life Insurance Awareness Month

No one likes to think about “what if” when it comes to protecting your family. What if something happens to you? What if something happens to your partner or parents? You need to consider how your family would do financially if the “What If” happens. Where would the money come from to pay for your […]

Medicare Part D Drug plan in the news

The Centers for Medicare and Medicaid Services announced that, starting in 2020, Medicare prescription drug plans can take advantage of a tool, called an indication-based formulary, that expands the choices of products they can cover, allowing plans to opt for cheaper drugs in certain cases. The announcement Wednesday is the latest part of the Trump administration’s blueprint aimed at lowering prescription drug costs that have spiraled upward in recent years.

Medicare Part D Changes

BACKGROUND ON THE PART D COVERAGE GAP AND LEGISLATIVE CHANGES SINCE 2006

Under the original design of the Medicare Part D benefit, created by the Medicare Modernization Act of 2003, when Part D enrollees’ total drug spending exceeded the initial coverage limit (ICL), they entered a coverage gap. Enrollees who did not receive low-income subsidies (LIS) were required to pay 100 percent of their drug costs in the coverage gap until their out-of-pocket spending reached the threshold amount that qualified them for catastrophic coverage. (The coverage gap does not apply to beneficiaries who receive low-income subsidies.) In 2007, the first full year of the Part D benefit, 8.3 million Part D enrollees (32 percent of all enrollees) had total drug costs above the initial coverage limit and in the coverage gap (Figure 1). This total includes 3.8 million non-LIS enrollees who were required to pay 100 percent of their drug costs out of pocket in the coverage gap.

Cost of Employer Health Coverage to Rise 5% in 2019

QWhat should I expect to happen to costs and coverage for my employer's health insurance plan for 2019?

AYou can expect the cost of medical and drug benefits to rise by 5% in 2019, according to the annual health care survey by the National Business Group on Health.

This would be the sixth consecutive year with a 5% increase, with premiums and out-of-pocket costs for employees and their dependents averaging $14,800 next year. Fortunately, employers continue to cover 70% of that tab, on average, with workers picking up the rest.

HIPAA: Why is it important to me?

More than 20 years ago the Health Insurance Portability & Accountability Act (HIPAA) became law. Today, as a result of this law, we assume our private health information will always be protected. Before HIPAA When you think of HIPAA it may feel like privacy overkill to you. Yet, before HIPAA was law, more than one-third […]

The Medicare True-False Quiz: Test Your Knowledge

Health care costs are one of the biggest concerns for retirees. For most American retirees, Medicare is their primary health care plan. Medicare is complicated, and understanding it is crucial to making smart decisions to help control health care costs. Unfortunately, research shows that many people don't. For instance, a report from The American College of Financial Services showed that only roughly 25% of those ages 60 to 75 could pass a retirement income literacy quiz that included a number of questions about Medicare.

Is Medicare Supplement Plan F Going Away?

Many of our clients have asked, why is Medicare Plan F going away?  The short answer is the government believes that folks that have a Plan F utilize their Supplement insurance more than their counterparts that do not have the Medicare deductible covered. Since Plan F covers that deductible, it is going to be phased out for new enrollees.

Follow these tips to lower your grocery and restaurant costs

10 Ways to Save Money on Food

Follow these tips to lower your grocery and restaurant costs

Medicare is projecting  a 5% Decrease in 2019 Part D Plan Premiums

The Centers for Medicare and Medicaid Services (CMS) recently announced that the 2019 projected national average weighted monthly premium for Medicare Part D prescription drug plans will decrease to $32.50 from the 2018 average premium of $33.59.  This average premium was calculated using stand-alone Medicare Part D prescription drug plans (PDPs) and Medicare Advantage plans with prescription drug coverage (MAPDs) combined and weighted by enrollment – so you may find that 2019 stand-alone Medicare Part D plans actually have a higher average premium when not considering the $0 or low-premium MAPDs.  

Seven Key Facts to Know Medicare Supplement Policies 

Are you approach your 65th birthday or thinking about switching from a Medicare Advantage Plan to Medicare Supplement Plan (also known as a Medigap policy)? If so, here are seven things to consider. First, you must have Medicare Part A and Part B. If you have a Medicare Advantage Plan, you can apply for a Medigap […]

When You’re Not Feeling Well Do You go to the ER, Urgent Care or a Retail Minute Clinic?

You wake up with a horrible headache, fever and dizzy. You feel sick all over.  You think you should see a doctor or a nurse but it’s Sunday and your primary physician doesn’t have office hours today. Who do you call for to get treatment? Do you call 911 for an ambulance to take you […]

When You’re Not Feeling Well Do You go to the ER, Urgent Care or a Retail Minute Clinic?

You wake up with a horrible headache, fever and dizzy. You feel sick all over.  You think you should see a doctor or a nurse but it’s Sunday and your primary physician doesn’t have office hours today. Who do you call for to get treatment? Do you call 911 for an ambulance to take you […]

Medigap Enrollment and Medicare Supplement Update

Key Findings

  • The share of beneficiaries with Medigap varies widely by state—from 3 percent in Hawaii to 51 percent in Kansas.
  • Federal law provides limited consumer protections for adults ages 65 and older who want to purchase a supplemental Medigap policy—including, a one-time, 6-month open enrollment period that begins when they first enroll in Medicare Part B.
  • States have the flexibility to institute consumer protections for Medigap that go beyond the minimum federal standards. For example, 28 states require Medigap insurers to issue policies to eligible Medicare beneficiaries whose employer has changed their retiree health coverage benefits.
  • Only four states (CT, MA, ME, NY) require either continuous or annual guaranteed issue protections for Medigap for all beneficiaries in traditional Medicare ages 65 and older, regardless of medical history (Figure 1). Guaranteed issue protections prohibit insurers from denying a Medigap policy to eligible applicants, including people with pre-existing conditions, such as diabetes and heart disease.
  • In all other states and D.C., people who switch from a Medicare Advantage plan to traditional Medicare may be denied a Medigap policy due to a pre-existing condition, with few exceptions, such as if they move to a new area or are in a Medicare Advantage trial period.

Life Insurance Facts to Consider

Many of us take life insurance for granted. If your employer offers it to you, it’s probably something that you never stopped to review. If you don’t have it as an employee benefit when was the last time you reviewed your coverage. Consider if these statements apply to you You have life insurance and the […]

It’s Summertime – Make Sure Your Staying Cool!

The weather is finally warming up.  You’ve taken off all of your layers, hats, scarves and gloves.  Now, you and your family are ready to enjoy the warm sun. But, have you thought about what it takes to stay safe from the hot sun during the summer months. Did you know that in 244 people died […]