My name is Amanda, and I had never anticipated being a caregiver or being responsible for my mother who has usually done most of the caregiving in my family. It is really stressful for me and my siblings to find information about taking care of my mom since we try to do it ourselves, being on a limited budget. However, we don’t always have time, and working with an agency can be rather expensive. I found a great website called TheCaringSpace.com where you can post a listing for free and get connected with caregivers in your area. It is a great option for people who want to independently connect with caregivers in an affordable, easy way without working with a third party. The site even allows caregivers to provide background checks and references so you don’t waste your time on people who aren’t serious. There is a lot of good information provided for people like me who don’t really know the ropes when it comes to caregiving or where to start when it comes to seeking respite care for my family.

Thanks!

Amanda

Authors Opinion

That is probably the only Medicare cost that will remain the same for 2009. I don’t have the numbers yet, but I would expect the Part B deductible of $135 to increase slightly. I would also expect the Part A deductible of $1,024 to increase as well. If you have a Medicare Supplement, one or both of these costs are probably covered for you.

Medicare Supplement premiums are not tied to a calendar year. Most Medicare Supplements will have annual increases in premium which you will incur on the anniversary of your policy.

Lastly, Medicare Advantage plans and Prescription Drug plans do have a calendar year contract. I expect that most of these plans will have an increase as well. These increases would go into effect starting January 1st, 2009.

If you have any questions, as always, simply fill out our contact form and we’ll get back with you usually within one day.

Part A - Hospital - You automatically get Part A when you turn 65 if you have worked and paid into Medicare for at least 40 quarters. This coverage will pay 100% of Medicare approved costs when you are admitted into a hospital, AFTER you pay the per hospital visit deductible of $1,024 (this is the 2008 deductible).

Part B - Medical - This part is optional. You will have to pay for it usually as a deduction from your social security check. The cost for most people is $96.40 per month.  If you make more than $85,000 as an individual or $170,000 as a couple, your monthly premiums will be higher. Part B pays 80% of your doctor, outpatient and other Non-Hospital costs, AFTER you pay an annual Part B deductible of $135.

Note: Do not get “PART A” and “PART B” confused with “PLAN A” and “PLAN B” which are Medicare Supplement plans. There are 14 Medicare Supplement “Plans” which are lettered Plan A - Plan L.

There are two more “Parts” to Medicare - Part C and Part D

Part C - Medicare Advantage - You have probably heard the term Medicare Advantage Plan by now. These insurance plans are also called Private Medicare and there are quite a few different flavors including, MA, MAPD, HMO, PPO, PFFS. I’m not going to get into each type now. The most important thing to know about Part C plans is this. They are NOT the same as original Medicare. They are NOT the same as a Medicare Supplement. Click Here for a detailed description of the differences between Medicare Supplements and Medicare Advantage Plans.

Part D - Prescription Drug Plan - Part D plans are optional, like Medicare Supplement Plans. Part D pays for some of your prescription drug costs throughout the year. Part D plans run about $30 per month. You generally keep your Part D plan from January 1 - through December 31st of each year. You can change Part D plan each year between November 15th and December 31st. The new plan will go into effect on January 1st. Click Here for detailed information on Prescription Drug Plans

I recently got the following question from a visitor to our website. My reply to her is below. I’m writing this pretty late at night, so for you Type A’s out there, if I have missed any of the finer points in my explanation, please let me know.

First of all, Medicare (CMS) creates the Medicare Supplement plans. Medicare Supplement Companies DO NOT create the plans. Whenever you see a copy of the Medicare Plan Table (see below) you will notice they are all the same - same plans, same options, same check marks, same percentages. No matter which Medicare Supplement company sends you the table, they are simply giving you the standardized table that Medicare created for everyone to use. This is a VERY important point to know. 

Click on the table above to see a larger view.

Medicare Supplement companies simply select the plans that they wish to re-sell and they put their price on it. This is another important point. Even though Medicare standardizes the plans, they do not standardize the prices. Companies can charge whatever they want to for the plans they sell. That is why you will see tremendous variations from one company to another for exactly the same plan.  For example, if you are a 65 year old female living in Gwinnett county and do not use tobacco, you can get a Plan F from one company for $119. The same Plan F is currently available from another company for $220. That is a $1,200 a year difference for EXACTLY the same plan. If you get your plan from company B, you are tipping them $1,200 per year.

So, why do most people go with Plans F & G

There are several reasons. First, more companies offer plans F&G. They are newer, and generally provide a better value for your money. Here are a few comparisons.

Plans C&F are very similar except F adds coverage for Part B excess charges. These charges rarely occur, but if they do, they could create a sizable cost to you. For example, let’s say you have a test proceedure, and the healthcare facility charges $1,000. Medicare will approve a lesser amount, let’s say $600. Healthcare facilities are allowed to charge up to %15 more than Medicare approves. This is called an “excess charge.” So 15% of 600 is $90. If you have Plans C, D or E, you would be responsible for that $90. Plan F would cover 100% of that $90, and Plan G would cover 80%. So with a Plan G, you would have to pay a whopping $18.

D,E&G are fairly similar. D&G cover at home recovery up to $1,700, E covers up to $120 of Preventive Care not covered by Medicare. Neither of these two charges occurs very often. Most preventive care is now covered by Medicare, and for one reason or another, most follow-up home visits are also covered by standard medicare and your supplement. We just don’t see the at home recovery charges occurring very often.

So the real choice most people make is between F & G. The big difference between these two is the Annual Part B deductible of $134. Plan F covers this annual charge. Plan G does not. So why would go with a Plan G? There is a good reason. Many Medicare Supplement companies price their Plan G’s at about $200-$250 less than a Plan F. Why pay $200 more in premium for a Plan F, just to save $134?

The other difference between Plan F and G is the excess charges. Plan F pays 100%, Plan G pays 80%. As we discussed earlier, most doctors don’t charge any excess, so this usually doesn’t come into play, and as we showed above for a $1,000 charge, you would probably end up paying about $12 if you had a Plan G.

So, in a nutshell, Southern Senior Care typically recommends Plan G. The only time we recommend a Plan F is when a client lives in a zip code where the prices between Plan F and G are less than $134. Then you might as well go with an Plan F.

I hope this reduces some confusion and does not increase it. As always, if you have any questions at all, please contact us by phone, email, contact form, or chat.

As more and more of the baby boomers become aware of the devastating financial and emotional effects that a long term care need can have on their family, the average age that people purchase LTC insurance has been steadily dropping every year. Government awareness programs advising people to look into this type of insurance is also causing people to get educated on how these plans work and to start early. LTC insurance is surprising affordable when you buy it at a younger age, so more and more people are simply taking advantage of it sooner.  My own personal experiences with my elderly parents and in-laws in nursing homes and assisted living (all paid out of their own pocket) caused my wife and I to purchase our plan when I was 52 and she was 50. I happily pay the premium every year, even though in the back of my mind, I hope I never have to use the insurance at all. Statistically, my wife has a much better chance of using the plan than I do.

The cost of purchasing LTC insurance goes up every year you delay. Carriers raise their rates for new purchase periodically too. The older you get, the faster it rises. As one starts to move into their early to mid 60’s, you begin to enter into what the mathematicians call the “exponential curve” of rapid price increases. The good news is that when you buy a LTC plan from a quality carrier, you are essentially “locking in” your rate for the rest of your life. Now it is true that the rates on existing policies can and do in fact increase, but many of the top carriers in the industry have a long history of little or no rate hikes. No matter when you purchase a plan, it is always going to offer you tremendous protection for a fraction of the cost of an extended nursing home stay.

Sadly, as we grow older, many of us also get less healthy. Blood pressure, arthritis, diabetes, and other ailments show up frequently as we get into our late 50’s. Many of us simply don’t take good care of ourselves, and others of us are a product of our heredity. LTC carriers give preferred health discounts to those who qualify of between 10% and 20%…so it pays to be healthy. There are a lot more healthy 55 year olds than 65 year olds out there.

Back to the original question….when should you buy LTC insurance? Although you can buy it at any age up to 84 with some carriers as long as you can medically qualify, I would urge everyone to start considering it by age 50, and try to get it in your early to mid 50’s if at all possible. If you can handle the premiums at that time, it can be a great value……and with the power of a 5% compound benefit increase, the benefit you purchase at age 50 will immediately start growing. This will provide you with a huge plan of protection by the time you statistically will most likely need the coverage, which is in your 80’s.  In the long run, even though you start paying the premium sooner, the overall amount of premium paid out can be less by starting early.

Everyone’s financial situation is different, and no one plan fits all. Not everyone can start at age 52. You may have to wait until the kids get through college to afford LTCi. You may first need to move to a more cost effective high deductible or HSA eligible health insurance plan, or wait until you are on Medicare, so you can free up the funds to pay for LTC insurance. If you are already 65 and reading this blog, then the time to buy LTCi is before you turn 66….assuming LTCi makes sense for your situation. The key is to first learn more about how LTC insurance works by speaking with an experienced LTC agent representing a variety of carriers and who can advise you as to all your options.

I hope this answers the question, but I would be happy to hear your thoughts.

On July 15th, General Motors announced that retired salaried employees 65 and older will lose their GM medical benefits. In exchange, GM will increase pension payments by $300 per month. My father is a retired GM employee, so I am very familiar with this situation.

The information below will hopefully answer some of your questions, and eliminate some of the fear, uncertainty and confusion, that you are feeling. Most General Motors retirees have had Medicare since they turned 65. You should have a red, white and blue Medicare card in your wallet or purse like the one below.

You will see two dates on the card, a Hospital (Part A), and a Medical (Part B) date. These are the dates that you enrolled in each part of Medicare. Your GM insurance is your “Secondary” insurance. It pays some or all of what Medicare does not cover. Medicare also has two other “parts.” Part C is the name for Medicare Advantage Plans. Part D is Medicare prescription drug coverage.

Medicare Supplement = Medigap

Medicare Supplement Insurance is the same thing as Medigap Insurance. Some people call it Medicare Supplement because it “supplements” Medicare. Others call it Medigap, because it fills in some or all of the gaps that Medicare does not cover.

Let’s keep this simple

What you need to do, is select a Medigap plan for your secondary insurance, and a Part D plan for your prescriptions. The $300 increase in your monthly pension check is more than enough to cover a comprehensive Medicare supplement and a Prescription plan. You can even add dental plan and final expense life plan and still come out ahead.

Medigap plans are Standardized

What does this mean? It means that Medicare designs the Medigap plans. There are over a dozen Medigap plans. They each have a letter designation A-L. For several years, Plans C, D, and E were the most popular, now days most retirees go with Plan F or Plan G. The most important thing to remember is this, and I’m going to say it several ways to emphasize the point:

• Plan F is Plan F no matter what company you get it from
• There are no differences between plans of the same letter from different companies
• Plans of the same letter are 100% identical
• The only difference between like plans from two different companies is the premium

If you have a fast Internet connection then click on the following link to download a booklet from Medicare called “2008 Choosing a Medigap Policy” and be sure to read the first paragraph on page 14. What this means is that once you decide which plan you want, you need to select the Insurance Company that has the best premium on that plan.

Important Dates to Remember

Since you are losing your GM group coverage under no fault of your own, Medicare provides a “Special Enrollment Period” for you. This SEP means that your application to ANY Medigap Plan and ANY Prescription Plan is Guaranteed to be accepted.  This means that you should select the Medigap plan with the lowest premium you can find from a reputable Medicare Supplement Insurance Company. In some states, if you use tobacco, you will still get Non-tobacco rates during your SEP.

What Should You Do Now?

If you live in Georgia, Tennessee, South Carolina or Alabama, you can call 1-800-315-6898 and we can answer all of your questions. You can also Click Here to Submit Questions regarding GM retiree Health Insurance. Also feel free to post questions or comments below. We’ll get back with you usually within one business day.

I hope this information is helpful. The switch from a Group health insurance plan to a Medicare Supplement Plan is confusing at first, but you will soon realize that if you select the right plan, you will still be covered very well. Many people may find that they have fewer out of pocket expenses than before.

Conclusion

The majority of U.S. retirees do not have Group coverage, they have Medicare and a Medicare Supplement (Medigap) plan. If you talk to some of your friends and family with these plans, you will find that the vast majority of them are very happy with their coverage. Many experience NO out of pocket expenses at all throughout the year other than their premium. The simple fact is that Medicare and Medicare Supplements work very, very well most of the time, and I’m sure you will have the same great experience. If Southern Senior Care can be of any help to you, please let us know.

The senate passed House Bill 1633 on Wednesday July 9th, by a “veto proof” margin of 69-30. The bill passed through the house with an overwhelming 355 to 59 votes. So, even though the white house has threatened a veto, this bill will likely survive. So, what does that mean to the millions of retirees who have Medicare and Medigap Insurance, or a Medicare Advantage Plan?

There are many moving parts to this bill. The primary goal of the bill is to block a scheduled 11 cut to Doctors who treat Medicare Patients. Doctors are obviously happy about this. So if Medicare is going to continue paying this 11%, where is the money coming from. Well, it will be largely funded by cutting about 13 billion dollars in Medicare Reimbursements to companies who are offering private Medicare plans.

Also called Medicare Advantage Plans, these private plans have been extremely popular over the last two years and some estimates state as many as 20% of Medicare recipients are using a Medicare Advantage Plan. If there is a 13 billion dollar cut, then companies offering Medicare Advantage plans will do one of three things:

1. Increase the premiums of their Medicare Advantage plans
2. Decrease the benefits of their Medicare Advantage Plans
3. A combination of 1 & 2
4. Discontinue the Medicare Advantage plans

What should Medicare Recipients do?

Right now the smart thing to do wait and see what happens. The white house still has their say. And if the bill is vetoed, it is possible (though unlikely) that it will not pass again. If it does pass, it will not affect the premiums of Medicare Advantage plans this year. The 2009 annual enrollment goes from November 15 to December 31. It is during this time that individuals can switch from original Medicare to a Medicare Advantage plan or decide to disenroll from their Medicare Advantage plan and go back to original Medicare. This is also the time that you add or change Medicare Prescription Plans. 2009 premiums will all be announced before this time, so everyone will have the information they need to make an educated decision.

Additionally, Medicare “Open Enrollment” is from January 1 through March 31. You can make one change to your Medicare or Medicare Advantage plan during this time. However, you cannot add or remove drug coverage during the Open Enrollment. So you really have four and 1/2 months starting November 15th to study and make changes to your Medicare coverage. And then, worse case, you can change it again next November.

If you have Original Medicare and a Medicare Supplement

This bill does not affect Medicare Supplements the same. In fact, this is likely a good thing for Medicare Supplements. The doctors are continuing to get their reimbursements and Medicare Supplements will continue to pay the balance. Our recommendation to individuals or couples who currently have Original Medicare and a Supplement is the same as it has been - If you can comfortably handle the premiums of your Medicare Supplement (Medigap) plan, then keep it.

That said, also keep in mind that you can change Medicare Supplements ANY TIME you want. If there is a company offering the supplement you have for a lower premium, then you should certainly consider switching. Since Medicare supplements are standardized, the only difference to you is the premium. Let me repeat, if you have a Medicare Supplement “Plan F” from XYZ company and you are paying $200/month for it, and you can get a Plan F from ABC company for $150, then you should almost certainly switch to company ABC. By staying with company XYZ, you are simply “Tipping” them $600/year for providing their service.

As soon as we have more information on Medicare Bill 1633, we will post it on this blog.

AARP Medicare Supplement Plan Costs

NOTE: This information is valid for Georgia and some other states. Unlike most Medicare Supplement companies, AARP uses “Community Pricing.” This means that everyone who has an AARP Medicare Supplement Plan “F” pays the same premium regardless of their age. You may talk to someone whose monthly premium is not exactly the same as yours. That is because AARP offers several optional discounts that can reduce ones monthly premium:

1. Spousal Discount - If both partners have an AARP Medicare Supplement, then both receive a 5% discount on their premiums.
2. Electronic Payment Discount - If you pay for your AARP Medicare Supplement by automatic electronic monthly bank draft you receive a $2.00/month discount.

Is the AARP Medicare Supplement the Best?

As mentioned in the paragraph above and many other reports, Medicare Supplement Plans are standardized, which mean the benefits offered are the same from company to company. You will find The Medicare Supplement Plan chart in the marketing material from every company. So, the question of which medicare supplement company is best, does not have an easy answer.

What is an AARP Medicare Supplement?

Medicare Supplement Insurance helps pays some of the medical expenses that Medicare does not cover. Some of these expenses are:

• Annual Part B deductible of $134
• Part A Hospital deductible of $1024 (this is paid for every overnight hospital visit)
• 20% of Part B expenses

So, when you need medical care, you show your Medicare Card. The doctor, hospital or healthcare provider sends the bill to Medicare. Medicare pays for their part of the expenses that are on the “Medicare Approved List,” and then they send the balance of the bill to your Medicare Supplement Insurance company - in this case AARP. AARP then pays their part of the expenses. Here is the “KEY” to how Medicare Supplement Companies work. Notice, I said they pay their part? I did not say they review the expenses, or they decide how much they are going to pay, or debate with the doctor about how much they are going to pay. The Medicare Supplement Company pays the balance of “whatever Medicare Approves.” If Medicare approves a charge and pays, then the Medicare Supplement Company MUST pay their part, no questions asked. That is why when you talk to someone who has had a Medicare Supplement Plan in place for several years, they always say things like “My Medicare Supplement company is GREAT, they always pay.” That is because they have to according to the rules of Medicare.

So, What is the Best Medicare Supplement Plan?

Now that we’ve discussed a little more about what Medicare Supplement Companies do and what a Medicare Supplement Insurance is, I’m going to refer you over to a blog entry devoted to that question. What is the Best Medicare Supplement Plan?

When can I change my Medicare Supplement?

Any time you want. That’s right. You could change Medicare Supplement Insurance every month if you wanted to. Realistically, you should review your rates every year, and you will probably find that you will want to change your Medicare Supplement company about once every three-four years to save money. To change to another Medicare Supplement Provider you will need to answer several health questions. Click here to see a list of common questions.

When can I change my Medigap Plan?

See Above. A Medigap Plan is just another name for a Medicare Supplement Plan. They are identical. They are synonyms. The reason for the confusion is the word “gap” which is also used to describe the gap (donut hole) in coverage in the prescription plan. Medicare also uses the two terms interchangeably which adds to the confusion.

When can I change my Medicare Prescription Drug Plan?

You can “change” Medicare Prescription Drug Plans during the Annual Enrollment period between November 15 and December 31st.  If you “change” during the annual enrollment period , your new plan will start January 1st. If you have a Medicare Advantage Plan that includes Prescription coverage (an MAPD) plan, then you can change to another MAPD plan during the “Open Enrollment” period between January 1st - March 31st. Your new plan will begin on the 1st day of the next month. I have put the word “change” in quotes for a reason.

When can I change my Medicare Part D plan?

See above. A Part D plan is another name for Prescription Drug plan.

When can I change my Medicare Advantage Plan?

The rules for changing a Medicare Advantage Plan are similar to the Medicare Part D Plan. As long as you have Medicare Parts A and B (check your red, white and blue card), you can “change” to a Medicare Advantage Plan between November 15th and March 31st. You simply need to have one of the following:

1. Original Medicare (with parts A and B)
2. Original Medicare and a Medicare Supplement (Medigap) Plan
3. Medicare Advantage Plan

There is one difference that causes some confusion. If you do NOT have a Medicare Prescription Plan or a Medicare Advantage Plan that includes Part D, then between January 1st and March 31 you cannot change to a Medicare Advantage Plan that has Part D included. This would be “Adding” Prescription Drug coverage, which as we said above you cannot do except between November 15th and December 31st.

If you have any specific questions or comments, please submit them in the comments section below.