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Top 5 Changes to Medicare | 2019

enroll in medicare 2018

Are you informed on Medicare 2019?

October 15th marks the beginning of the Annual Enrollment Period (AEP), which means it’s time for seniors to review their drug and health care plans. You have until December 7th to enroll, so as you consider your options, here are the biggest new changes that are in play.

1. MEDICARE ADVANTAGE PLANS (PART C): Extending the Dis-Enrollment Period

After the AEP closes, Medicare Advantage plan enrollees now have a full 3 months to make one change: to either switch plans or opt out of Medicare Advantage plans altogether. For those who want to switch plans, this extension gives enrollees more time to review the plan they chose during AEP, and for those who opt out, they have more time to return back to Original Medicare and add a stand-alone Part D Prescription Drug Plan.
This extended dis-enrollment period is from Jan. 1 – Mar. 31.

2. PART D: Premiums projected to go down again!

According to the CMS, average Part D premiums are projected to go down for the second year in a row. The decreases vary among prescription plans, and some may not change, but as a whole, seniors can expect to see lower prescription drug costs.

3. PART D: Congress is closing the Donut Hole early for brand-name drugs

Yes, you heard that right, Congress is ahead on a deadline. The Affordable Care Act requires that insurance companies close the gap or “donut hole” for all prescription drug coverage by 2020, but for brand-name drugs, Congress is closing it in 2019. What is the donut hole? It’s been a gap between spending thresholds in between which prescription drug costs were not covered. For example, in 2018,  it meant that your Part D prescriptions were only covered up to $3,750, and coverage only kicked back in after you had spent $5,000 out-of-pocket.

Although average premiums are going down and the donut hole is being closed across all plans, the Annual Enrollment Period is the only time of year you can change your Part D plan, so you should definitely consider reviewing it. Part D plan all differ slightly in their coverage in regards to different prescriptions, so seniors should look at the available 2019 options to make sure they are still on the best plan for their current prescription needs.

4. PART B PREMIUMS: Increase slightly from 2018

For new enrollees and those who are not on Social Security, Part B premiums will go up by $1.50 from $134/month in 2018 to $135.50 in 2019. In addition, the Medicare Part B annual deductible will show a slight increase to $185 (from $183).

For those who are on Social Security, read on. Part B premiums are deducted from your Social Security check, so last year you saw premium increases keeping pace with your Cost-of-Living-Adjustment (COLA). Why? During years where there is no Social Security COLA, Part B premiums cannot increase for Social Security beneficiaries regardless of increases elsewhere, like for new enrollees. 2019 is bringing another significant COLA increase of 2.8% to Social Security, so Part B premiums may increase to match that (we’ll update this post when these numbers are announced. So, your Social Security checks will increase, but that extra money may go to pay your higher Part B premiums (we’ll keep you posted!).

5. PART B PREMIUMS: Higher-income individuals still pay a higher Part B surcharge

Many high earners saw a significant increase last year with a change in the income brackets. For 2019, CMS has added an additional bracket at the top for the highest earners. While in 2018, the highest bracket started at $160,000 for single ($320,000 for married), in 2019, the highest bracket (and premium) starts at $500,000 for individuals and $750,000 for married couples.

The new higher income brackets look like this:

  • $352.20/month:
    Individuals: $133,500.01–$160,000
    Married/Joint: $267,001.01–$320,000
  • $433.40/month:
    Individuals: $160,000–$500,000
    Married/Joint: $320,000–$750,000
  • $460.50/month:
    Individuals: $500,000+
    Married/Joint: $750,000+

YOUR NEXT STEPS?

Knowing the changes for 2019 can help you make the most informed decision about whether you should change your Medicare plan. But please remember that any savings you may discover by switching plans have no effect if you do not enroll by December 7. Open enrollment has only one deadline and no extensions.

You can enroll for Parts A and B online through Social Security, by calling the Social Security office at 1-800-772-1213, or by visiting in-person at a Social Security office. The majority* of new seniors have a 7-month window to sign up for Original Medicare—3 months preceding and 3 months following your 65th birthday.
(*If you are between the ages of 62-65 and already receive SSI benefits, you will be auto-enrolled in Medicare.)

Once you’ve signed up, make sure you have a trusted and independent Medicare agent help you decide between a Supplement + Part D plan and a Medicare Advantage Plan. Only with an agent or firm who is independent of any partnerships or contracts with insurers are you guaranteed unbiased assistance.

Email or call Robert today to get on his November calendar to help you make any changes you need.

 

How To Avoid Identity Theft in 2018

identity-thief-graphic

4 Tips to Protect Yourself from Identity Theft in 2018

In 2017, 1 in 15 people had their identity stolen, equalling 16.7 million victims. Once identity thieves have your personal information, they can access your bank account, make unauthorized charges to your credit cards, open new utility accounts, or get medical treatment on your health insurance. An identity thief can even file a tax refund in your name and get your refund. Identity theft can happen to anyone but seniors are especially likely to be victims. There are a couple reasons why seniors are often targeted:

  • Seniors usually have more money in their savings than the younger generations.
  • Depending on their living situations, seniors personal information travels through many different people and groups on a regular basis.
  • Identity thieves take advantage of seniors’ trusting attitudes. Seniors are less likely to be suspicious of unusual emails, calls, or requests and therefore are often not expecting to be taken advantage of.
  • Lastly, when identity theft has happened, seniors are less likely to report it and discuss it with their family. Often, many fear that reporting identity theft to their family will indicate they are unable to handle their finances on their own.

Here are four simple steps seniors can take to minimize the risk of identity theft and make yourself more aware of potential threats:

hacking-lock-icon1. Understand the Threats

Identity theft is much more than spam emails. It can take the form of tax fraud to medical billing to phone scams. In all cases, they seek to obtain your personal information—which many include your SSN, your credit card numbers, or your billing information. Here is a great resource to learn more more about your top identity theft threats.

 

Social-security-card-example2. Guard your personal numbers

Studies show 88% of older Americans are more likely to share personal information online than their children or grandchildren. It is important that you never provide personal information, such as your Social Security number, credit card number, date of birth, checking or savings account numbers over unsecured outlets, including email, social media and phone calls you did not initiate.

 

paperwork3. Secure your paperwork

Many times, easily accessible mail and confidential documents landing in the wrong hands is a large issue for seniors. Having a locked mailbox is a first step to eliminating this issue. Once you have received and finished with the documents, you do not want to just throw them into the trash. Purchasing a small paper shredder to destroy the paperwork is a quick and easy way to reduce the risk of it getting into the wrong hands.

 

credit-card-statement-review4. Review your statements.

Regularly checking your bank, credit card, and other statements helps to identify suspicious transactions or differences. If something looks unfamiliar, take action immediately with your bank or organization.

 

Takeaways:

All in all, identity theft is a serious crime and can be very damaging for all affected by it, especially seniors. Following these simple steps stated above will help reduce your risk at becoming a victim. If you believe that you are a victim of identity theft, this page from the AARP website will help you navigate who to call and what to report. This page from the online guide to the US government also lists instructions on actions to take should you need to report identity theft.

 

Who We Are

Griffin Insurance Solutions is an independent agency that offers plans from 15 different insurers. We understand that each client is a unique individual, and we want to help you find the best plan and the right insurer. We ensure that your options remain flexible so you can use the providers and doctors of your choice. We’ll happily address your questions and concerns and help you find the best plan for you. Contact us today for in-person appointment by email or phone at 919-704-6147 or 800-774-1434.


Sources:

  • https://www.ftc.gov/sites/default/files/documents/public_comments/ftc-seeks-public-input-how-identity-theft-impacts-senior-citizens-project-no.p065411-00009%C2%A0/00009-83187.pdf
  • https://www.huffingtonpost.com/jim-t-miller/10-ways-seniors-can-avoid_b_11180036.html
  • https://www.experian.com/blogs/ask-experian/protecting-seniors-from-identity-theft/
  • https://www.identityforce.com/blog/identity-theft-odds-identity-theft-statistics
  • https://www.aarp.org/aarp-foundation/our-work/income/elderwatch/report-fraud/https://www.usa.gov/identity-theft#item-208988

Why and How Seniors Can get more Sleep

sleeping-feet-bed

Top 7 Ways Seniors can Get More Sleep and Why they Should (#5 will surprise you!)

Have you ever heard the myth that seniors need less sleep than other age groups? That now that you’re older, having shorter, restless sleeps is to be expected and normal? Both the Center for Disease Control and the National Sleep Institute stand to debunk that rumor.

The CDC defines seven hours as the minimum for all adults. Getting daily sufficient sleep is key for a healthy lifestyle and is identified as one of the top five health behaviors to prevent chronic disease for people of all ages. But as we age, our sleep cycles change and the body respond differently to sleep and seniors do often find themselves having a harder time either falling asleep or staying in a deep, continuous sleep—from a variety of sleep disorders (click here to learn more about those). But a few life habits can help you capture more Zzzs.

SleepDuration-Recommendations1. Find your sleep number

It is defined as medical equipment prescribed by your doctor for use in the home that can withstand repeated use, is used for a medical reason, and has an expected lifetime of at least three years. DME can only be prescribed to you by your doctor, and—depending on the type of equipment—you may be required to either rent it or buy it through Medicare.

routine-clock-icon2. Create a Routine:

Once you’ve identified the right amount of sleep for you, create a routine that will allow your body to fall into a rhythm to increase your chances of a better night’s sleep. Once you’ve made it, stick to it.

  • Going to bed and waking up each morning at the same time—including the weekends—will help to your sleep-wake cycles become consistent, allowing for your body to understand when to be active and when to prepare for sleep.
  • Regular and consistent exercise, especially aerobic activities, can promote good sleep, as long as it is not within three hours of your bedtime. Northwestern University studied how aerobic exercise affected middle-aged and older adults diagnosed with insomnia. The study showed that participants who regularly exercised saw dramatic improvement in quality of sleep, reporting fewer depressive symptoms, more energy, and less daytime sleepiness.
  • Avoid daytime napping. Studies have shown that naps can increase symptoms linked to insomnia and disrupt your sleep-wake cycles into the night.

peaceful -bedroom3. Create a Sleep Zone

Your bedroom should be the place where you go to relax and sleep. By eliminating other activities that take place in your bedroom, you allow your mind to understand that when you’re there, you should be sleeping. The room should be quiet, dark and cool. Also, find the right mattress and pillow for your preferred sleeping position. Having the right pillow and mattress is key in creating a comfortable sleep zone. Here’s a link that can help you when you are mattress shopping.

water-pouring
4. Limit Liquids Before Bed

Even small amounts can make it harder to stay asleep. Add that to the common bladder problems that face seniors and you get a disturbed sleep. Getting up in the middle of the night to go to the bathroom not only initially disrupts your sleep, but if insomnia troubles you, you may have a trouble getting back to sleep. Make sure to limit liquids in general close to bedtime.

sunny-grass5. Enjoy the Sunshine

Sunlight helps regulate melatonin and your sleeping cycles. Being outside during daylight hours triggers our mind and body into understanding this is when we should be awake. With that in mind, try to get at least two hours of sunlight a day. As always, it is important to use sun protection including sunscreen and proper eyewear when outside.

6. Unwind Before Bed

1. Those same “sunshine triggers” in our brain may get triggered at night by our favorite electronic screens. Turn off your TV and other electronics at an hour before bed—or at the minimum, 30 minutes. Using them before bed can adversely affect your sleep. To learn more, click here.

2. Studies show taking a warm bath before bed allows your body to relax and slow down as you prepare for sleep. The change in temperature from the warm bath to room temperature can also aid in helping you feel tired.

3. Relaxation techniques such as meditation or deep breathing before bed may allow your brain to let go and feel tired.

7. Plan your Dinner

Our diet diet directly affects our sleep.

  • Finish your dinner at least 3 hours before bedtime to reduce indigestion.
  • Consider your meal: Having large or spicy meals before bedtime can cause issues such as indigestion. High-sugar foods and refined carbs can stimulate your system when you’re trying to reach your full REM cycle.
  • Avoid night caps. The alcohol may initially make you feel sleepy, but will metabolize into stimulating sugars as your body digests it.

How your doctor can help:

As always, you will want to consult your physician to see if there an underlying medical reason causing sleep disruption or issues. These may be from a sleep disorder or any prescription or over-the-counter drugs that contribute to sleep disorders. When effects are serious and left untreated, they can take a toll on a person’s health and even put you at risk for cardiovascular disease, headaches, memory loss and depression. Depending on your situation, your doctor may recommend behavioral therapies, prescription medications or both, as part of your treatment plan.

How Medicare Plays in

It’s also important to note that Medicare Part B may cover Type I, II, III, and IV sleep tests and devices. To learn more about what is covered, who is eligible, and costs, click here. It’s important to talk to your physician prior to ordering a sleep test. You’ll want to confirm if the sleep study lab accepts Medicare assignment to determine costs for any sleep studies he or she recommends.

Your doctor or insurance provider can help you determine what is covered, but if you think you might be eligible for a sleep study and would like some professional guidance, we’re to help. Customizing a plan to your situation will help you both today and in the future.

How we can help:

Griffin Insurance Solutions is an independent agency that offers plans from 15 different insurers. We understand that each client is a unique individual, and we want to help you find the best plan and the right insurer. We ensure that your options remain flexible so you can use the providers and doctors of your choice. We’ll happily address your questions and concerns and help you find the best plan for you. Contact us today for in-person appointment by email or phone at 919-704-6147 or 800-774-1434

 


Sources:
https://sleepfoundation.org/sleep-topics/why-electronics-may-stimulate-you-bedhttps://www.webmd.com/sleep-disorders/guide/aging-affects-sleep#1https://www.helpguide.org/articles/sleep/how-to-sleep-well-as-you-age.htmhttps://www.nia.nih.gov/health/good-nights-sleephttps://mattresshelp.org/senior-sleep-guide/https://www.northwestern.edu/newscenter/stories/2010/09/aerobic-exercise-relieves-insomnia.htmlhttps://mattresshelp.org/mattress-reviews/https://www.blackburngroup.com/riskpro-news/the-five-key-health-behaviors-that-reduce-chronic-disease

How Medicare Covers Durable Medical Equipment

Crutch-Wheelchair-Disability

Does Medicare Cover Medical Equipment at Home?

Once you are covered by Medicare Part B (medical coverage), it’s important to understand all your options when it comes to medical supplies and equipment at home. Part B doesn’t cover common medical supplies such as like toilet seats, bandages and gauze, but it does cover other supplies defined as durable medical equipment, also known as DME.

What is considered DME?

It is defined as medical equipment prescribed by your doctor for use in the home that can withstand repeated use, is used for a medical reason, and has an expected lifetime of at least three years. DME can only be prescribed to you by your doctor, and—depending on the type of equipment—you may be required to either rent it or buy it through Medicare.

Some eligible items include:

  • Blood sugar monitors
  • Blood sugar (glucose) test strips
  • Canes
  • Commode chairs
  • CPM machine
  • Crutches
  • Hospital beds
  • Infusion pumps and supplies
  • Manual wheelchairs and power mobility devices
  • Nebulizers and nebulizer medications
  • Oxygen equipment and accessories
  • Patient lifts
  • Sleep apnea and CPAP devices and accessories
  • Suction pumps
  • Traction equipment
  • Walkers

Medicare will only cover your DME if your doctors are enrolled in Medicare. So your first step is to ask if they are enrolled. To be enrolled in Medicare, there are strict standards doctors must meet. If they are not enrolled in Medicare, your DME will not be covered. It’s also important to ask your DME suppliers if they participate in Medicare. For the lowest costs, you will want to choose suppliers that are participating. If they are participating, they will accept the Medicare-approved cost for the equipment (also known as assignment) and will not overcharge you. If suppliers don’t accept assignment, there’s no limit on the amount they can charge you. Be aware that some suppliers may be enrolled in Medicare but aren’t considered “participating.”

To find Medicare-participating suppliers in your area, visit the Medicare Supplier Directory.


How does my Medicare Supplement Plan work with this?

How Medicare covers the different pieces of DME varies depending on the piece of equipment. Your Medigap Plan will help to cover all if not part of the 20% of the Part B Medicare-approved costs. Knowing what “letter plan” you have along with calling your provider will help you determine if you have to pay and how much with each piece of DME.


What if I have a Medicare Advantage Plan?

Medicare Advantage plans (like HMOs or PPOs) must cover at least the same level of coverage as Original Medicare. But as with most Advantage Plan coverage, your doctor and DME supplier must be in-network to be covered. How your Advantage plan covers each piece of equipment will vary—primarily in whether they cover it as a purchase or a rental. If you need DME and are in a Medicare Advantage plan, your first step would be to contact your plan provider and find out your options. Ask specifically if the equipment you need is covered and how much it will cost you.

Need more guidance on this topic?

We are here to help navigate you through the Medicare maze, customizing a plan to your situation that will get you where you need to be today while preparing for tomorrow. Griffin Insurance Solutions is an independent agency that offers plans from 15 different insurers. We understand that each client is a unique individual, and we want to help you find the best plan and the right insurer. We ensure that your options remain flexible so you can use the providers and doctors of your choice. We’ll happily address your questions and concerns and help you find the best plan for you. Contact us today for in-person appointment by email or phone at 919-704-6147 or 800-774-1434.


Sources:
https://www.medicare.gov/Pubs/pdf/10110.pdf

Annual Wellness Visit


https://www.medicare.gov/coverage/preventive-visit-and-yearly-wellness-exams.html
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MPS_QRI_IPPE001a.pdf

Medicare-Approved Annual Visits

doctor-with-patient-exam

So what is a Medicare Approved Annual Visit?

Medicare Part B (Medical Insurance) offers many services, but will it cover an annual physical? The short answer is no. The long answer is that Medicare Part B doesn’t cover an annual physical, but it does cover other annual visits to evaluate your health and discuss any concerns.

So what does it cover?

During your first year of enrollment in Medicare Part B, you’re going to schedule a ‘Welcome to Medicare’ appointment with your doctor. It is a one-time appointment offered to all those enrolled in Part B during your first 12 months of enrollment. The visit will be free of charge (no deductible or copay) if:

  1. You are enrolled in original Medicare. (Prior to the appointment, confirm that your doctor accepts the Medicare-approved payment as full payment, or you will be stuck paying it out-of-pocket.)
  2. Or, you are enrolled in a Medicare Advantage plan. (Prior to the appointment, confirm that you have chosen a doctor in the plan’s provider network.)

This ‘Welcome to Medicare’ visit is strictly to identify your current health status and establish a baseline to create a personalized health plan of action moving forward. You will need to provide your doctor with your medical records (including immunizations), your family health history, and a list of all current medications—over the counter and prescriptions.

During this visit, your doctor will:

  • Assess your vitals
  • Discuss your family medical history
  • Perform a simple vision test
  • Discuss relevant and serious health concerns
  • Possibly suggest future test and screening appointments to be scheduled

Although it seems very similar to a physical, it lacks the preventative services and tests that physicals include. This visit is strictly to document a snapshot of your current health for comparison with future visits and to potentially catch serious health concerns early. To understand exactly what is included in this visit, click here.

What about my yearly exam?

Although the ‘Welcome to Medicare’ appointment is a basic discussion and look into your health, you can have access to annual wellness visits in the years following. To be qualified for these yearly wellness visits, you must remain enrolled in Medicare Part B for more than 12 months. These annual visits serve as checkpoints to evaluate your health plan, discuss any concerns, and to confirm any changes in your plan. You doctor helps coordinate a schedule for appropriate preventative services and creates a list of risk factors and treatment options. To understand all preventative services offered by Medicare, refer to Your Guide to Medicare’s Preventive Services. It will break down each service by what’s covered, how often, and who is covered.

Some highlights from the guide linked above include full coverage for the following tests:

  • Lipid blood panel to check cholesterol every five years
  • Colorectal cancer screenings every 12 to 120 months (depending on the test)
  • Mammogram screenings once a year

If you need more frequent testing than outlined above, you could be charged the Part B deductible, copays, excess charges, and coinsurance. This is where Medigap comes into play. Medigap may cover all or part of these costs, including many deductibles and copays. To learn more about your options, click here.

Your takeaways?

Medicare will not provide you with an annual physical, but through Medicare Part B you can schedule your one time ‘Welcome to Medicare’ appointment and future annual wellness visits (after your first year of enrollment). Through these appointments, you and your doctor will discuss and create a personalized health plan based on your health and wellness needs and situation.

Need more guidance on this topic? We help hundreds of seniors every year navigate through the Medicare maze. With options from 15 different insurers, we can customize the right plan for your health and finances and help you today while preparing for tomorrow. We understand that each client is a unique individual, and we want to help you find the best plan and the right insurer. We ensure that your options remain flexible so you can use the providers and doctors of your choice. We’ll happily address your questions and concerns and help you find the best plan for you. Contact us today for in-person appointment by email or phone at 919-704-6147 or 800-774-1434.


Sources:
https://www.medicare.gov/Pubs/pdf/10110.pdf

Annual Wellness Visit


https://www.medicare.gov/coverage/preventive-visit-and-yearly-wellness-exams.html
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MPS_QRI_IPPE001a.pdf