Raborn Insurance Associates

09/01/2020

The second in our Let's Review Series:
Let's review Medicare Supplements, Medigap policies. These optional policies you purchase once eligible/enrolled into Medicare Part A&B. These plans help pay all or most of YOUR Medicare deductibles/coinsurance on all Medicare approved charges. Every carrier MUST offer the same benefits on the plans, A-N, they decide to sell. When starting Medicare Part B you have 6 months to enroll into a Supplement with Guaranteed Issue protection (no health questions, no underwriting) Now a few bullet points:
1. You can change plans/carriers ANYTIME of the year. However, in most situations you must undergo underwriting for approval.
So DON"T WAIT until Medicare Annual Election Period (AEP).
2. Some carriers offer supplemental benefits not associated with health benefits, these can differ among carriers. Nurse hot line and Silver Sneakers are examples. WATCH FOR THESE SUPPLEMENTAL BENEFITS TO BECOME A MAJOR ROLE IN THE CARRIERS COMPETING FOR YOUR BUSINESS.
Already mid 2020 a SC carrier added $0 hearing exams and hearing aids for $699 and $999.
3. Plan F which pays 100% of all your costs for all Medicare approved charges is no longer offered to anyone new to Medicare Part A&B as of 1/1/2020. However, anyone with Medicare before that date can submit an application for Plan F with a new carrier offering Plan F at a lower premium.
4. Premiums typically bump up each year. In some states such as SC twice a year-at birthday and annual rate adjustment for all members.
5. There are some additional times you maybe eligible to purchase a supplement as a Guaranteed Issue right:
A. When first eligible for Part A&B you enrolled into a Medicare Advantage Part C, within 12 months you can opt to cancel Part C, and enroll into a supplement. For Guaranteed Issue rights, specific paperwork is required. Don't cancel or make this decision until you completely understand the how and when.
B. You are enrolled into a Part C plan and you move out of that plans service area. For Guaranteed Issue rights, specific paperwork
is required.
6. Supplements do not have network requirements. you can see any doctor as long as that doctor agrees to bill Medicare.
7. Supplements offer benefits NOT offered by Original Medicare such as out of US coverage, and an additional year of hospitalization after your 60 lifetime reserve days have been used.
8. Not all carriers offer all plans.
9. Rates vary with each carrier and can be based on gender, tobacco use, and county.
10. If you have a Part C plan and want to enroll into a Medicare Supplement, I recommend we submit the application no later than 1st of October.
Email [email protected]
Call/text 706.394.2605 for a current rate on specific Supplement plans A-N.

07/27/2020

Let's review PART D Prescription drug coverage for Medicare beneficiaries. GA and SC offer 28 stand alone prescription plans.
GENERAL THOUGHTS:
1. These plans must be as good or better than the annual Medicare guidelines for Part D coverage (2020 discussed below)
2. You must have Medicare Part A and/or B to enroll
3. If 65 years old, continue to work and keep employer group health coverage you MAY need to enroll into a Part D plan to avoid a Late Enrollment penalty, IF your current coverage is not considered credible. Medicare requires all Medicare eligible individuals be notified by October 15th concerning their plans coverage status- credible or non-credible
4. Plans vary by state
5. Plans have networks and may have preferred pharmacies for lower cost sharing
6. Medicare Standard guidelines can change each year
7. Each plan has a different formulary or list of covered medicines, as well as exceptions- IE prior authorization, step therapy, quantity limits
8. Medicare Advantage Part C may or may not include drug coverage
9. Extra help is available for individuals with limited income. Extra help assists with premiums, deductible, your costs and you do not enter the GAP phase discussed below. Maximum income and asset caps to qualify change annually.
10. When you have prescriptions filled, you will receive a monthly Prescription Drug Summary. Review and file for review
STANDARD 2020 MEDICARE GUIDELINES
Deductible
annual $435 You pay the full negotiated costs of a prescription
(the plan may not require a deductible for certain covered medicines, or eliminate it all together)
INITIAL COVERAGE PERIOD
You now have co-pay or coinsurance on covered prescriptions If you and the carrier spend a combined $4,020 at any point in the year, you enter the next phase
GAP
Your costs is 25% of the negotiated retail price of covered medicines. You remain in this phase until you have spent $6,350 (Medicare allows the 75% paid on your behalf during this phase to be included toward this maximum out of pocket total)
CATASTROPHIC PHASE
Your costs for covered medicines $3.60 generic, $8.95 name brand or 5% which ever is higher
CLOSING REMARKS
1. Once you are Medicare eligible, Manufactures coupons can not be used. However, you can use prescription discount programs such as Good Rx or a company such as Walmart/Kroger and others $4 list of medicines.. Be sure to inform the pharmacy of your plans. Dollars you spend will not count toward meeting the deductible etc
2. SOME manufactures offer assistance for Medicare beneficiaries while in the GAP phase. You must contact the manufacture and complete an application
3.By the end of September of each year, your current plan is required to send you a packet. Make sure you read the Annual Notice of Changes- this will compare your plan benefits for current year to the following year.
4. Remember this is insurance, so if you have questions contact your carrier customer service.

06/25/2020

Have you heard the phrase: "SNOOZE YOU LOOSE"? My prospects for Long Term Care (LTC) who delayed and now want to revisit this coverage discovered the delay has impacted premiums and choices. IF you are under 65 and LTC is an insurance to consider, I highly recommend you do so NOW. Covid 19 has impacted options. Over 65 will NOT be quoted by certain carriers, others stop offering at 70.

06/24/2020

Acupuncture coverage

LATEST NEWS FROM Medicare:
Acupuncture is now covered for Chronic low back pain. ONLY lower back pain.
Here is the link for the article.
https://www.medicare.gov/coverage/acupuncture

Is acupuncture coverage something you need? Learn about wellness services costs, holistic health options available to Medicare policy holders.

06/17/2020

SCAM ALERT Most Medicare members can NOT change their Part D or Part C Medicare coverage now. (Call me if you need to know if you are an exception). SO WHY ALL THE CALLS!
I and many of my fiends/clients have been bombarded with calls about their coverage. There has been several warnings about using the Covid-19 as a reason to scam you. Let me share how I handle these calls. 1. My phone numbers are registered with the Do Not Call program through the Public Service Commission (PSC). NO THIS DOES NOT STOP THEM, so A. I do not answer unknown out of area numbers, B. when I answer and hear the spill, I state, I would NEVER do business with you, you are NOT an ethical business for I am on the Do Not Call List. (Get ready for the click of hanging up). 2. Then your smart phone has a block feature where you can block that number. 3. You can report the number to the PSC online is the fastest way.
HOW TO REGISTER YOUR NUMBER WITH THE PSC: using the phone you want to register call 1.888.382.1222. It takes 30 days to be on the list. This does not stop all calls-political or charity calls are some of the exceptions.

05/07/2020

WOW, Great news for Humana Part C Medicare Advantage clients. Humana will waive all cost sharing- co-pay, coinsurance, or deductible to the members primary care, non-facility based behavioral health and telehealth vists for the rest of 2020. They are also sending to each members home a safety kit which includes 2 washable masks and safety/health information.

04/02/2020

Starting Medicare A and B or Part B for the first time? Let me introduce myself:
John Raborn, health agent for 15 years. I represent carriers offering options for Medicare members in the states of GA and SC. I am a Medicare beneficiary myself. I represent 25+ Medigap/Supplement carriers, AND most Part C Medicare Advantage plans. I can compare multiple options based on YOUR SPECIFIC NEEDS. All this can be done electronically, over the phone, or through the mail. I do NOT charge a consultation fee, Medicare does not allow agents to charge. IF you choose to enroll, the carrier pays a commission. The premium/benefits are the same offered directly by the company. Why call an independent agency? I know in specific detail the differences in benefits each offer.
John Raborn 706.394.2605, [email protected]

02/23/2020

What's the next "big" event in your life? Many we plan, some just come our way, especially the unseen health issues.
HEALTH CONCERNS: If you or a spouse are our clients, I want to encourage you to keep me in the know. We rejoice with those who rejoice and weep with you who weep. This past week I mailed out about 10 Get Well, Encouragement, or Praying for you cards. I appreciate
PLANNED
This year my second granddaughter will graduate High School. I have 11 and feel so blessed. Friday, Gail and I were driving our 3 year old granddaughter home. (You need to know I will be part of a Variety Show at our church at the end of March, to raise $ for a youth camp) For weeks we have been encouraging her to be a part of the show, sing a song or dance (she takes dance). Gail brought up the event once again in the car, so she says, "I want to do comedy like Papa John and make them laugh."
That girl and all my grands have many more "big" moments ahead in their life, mine so many less, but I appreciate how much joy we each can give to one another.

01/10/2020

LIFE INSURANCE NEED TO KNOW FOR 50+ ADULTS:
1. TV ads stating no health questions- This is a Guaranteed Issue policy and is the most expensive offered, example Colonial Penn with Alex Trebek. These plans do not pay full benefits in the first several years for death due to illness.
2. Life offered to AARP members is term coverage, rates increase every 5 years and you can not renew after the age of 70.
3. Current life coverage- If you own a Universal Life policy and receive an annual report you need to pay close attention to the Guaranteed section of your report- AT WHAT AGE DOES YOUR COVERAGE END USING THE GUARANTEED GROWTH IN YOUR POLICY. The cost of coverage increases each year and the non-guaranteed area reflects current interest rates being paid by the carrier. These rates can decrease to a guaranteed amount listed in your policy. COUNTLESS TIMES I AM APPROACHED BY INDIVIDUALS WHO RECEIVE SIGNIFICANT PREMIUM INCREASE NOTICES to keep their policy active.
4. If married, do you have enough investments to replace your current income contribution after your death?
FINALLY
Our agency represents multiple carriers offering term, permanent, and whole life final expense plans. Let's discuss your need to determine the right coverage for your family.

12/16/2019

Medicare clients with Part C Medicare Advantage plans: know how your plans work:
HOSPITAL ADMISSION
Hospital co-pays are for a specific amount for a specific number of days. If you are released and readmitted the co-pay/day count starts over. ASK ABOUT HOSPITAL INDEMNITY COVERAGE to pay the co-pay.
DENTAL/VISION
Benefits and how you receive them vary:
1.Some offer only specific benefits listed in the Evidence of Coverage (EOC). To receive you must use a network of that carriers providers.
2. Others have no network and will reimburse for benefits received up to the amount listed in the EOC.
DIABETIC SUPPLIES
Most carriers have preferred testing monitors and many offer $0 co-pay on supplies for that equipment.
Take advantage of every benefit to maximize your low
est expenses possible.

12/12/2019

Up coming dates concerning medical insurance:
Open Enrollment for medical plans for under 65 ends Sunday December 15th.
Medicare Open Enrollment Period January 1 to March 31. Anyone with a Medicare Advantage Part C plan can make one change during this 3 month period. Change to a different Part C plan, or go back to Original Medicare and select a stand alone Part D plan.
Counties in Georgia where Aetna did not renew their Part C plan have until 2/29 to select a plan. Beware, if you do not do so by 12/31 your drug coverage ends with your plan on 12/31/2019.
What options are available year around:
Short Term Medical health insurance
Dental/vision coverage
Ancillary benefits can be purchase: plan to pay hospital costs, cancer, accident plans
Medicare Supplement change or elect for the first time
Questions?, email or call me:
[email protected], 706.394.2605

11/15/2019

Medicare premiums and deductibles are out:
Part B standard premium is $144.60 as of 1/2020.
Your COLA raise is 1.6%.
The Part B deductible is $198 beginning 1/2020.
How does that affect you: Medigap/Supplement clients with Plans G or N will now meet the $198 deductible before Part B benefits are paid.
Part C Medicare Advantage clients with most plans do not have a deductible before co-pays start. Check with me if you are unclear on your plan benefits.

10/25/2019

Should a veteran who did NOT retire with the military but uses the VA for health coverage, start Medicare Part B when eligible? This is a personal and financial decision. Part B 2019 base premium is $135.50. An artice in AARP magazine this October stated- The Office of Inspector General found in 2017 the VA wrongly denied $53.3 miliion in non-VA claims. IF a vet starts Part B he/she now has a number of options. here is one choice: Select a Part C Medicare Advantage plan that offers a Part C buy down (puts $55 of the deduction back into the Social Security check). Then if they need to see a primary doctor at a non-VA site pays $0, and has a $90 ER copay. $50,000 out of the US emergency benefits) receives $750 in dental benefits and much more. This is at no additional costs to them. I am a Vet, I use the VA, I want to help every vet get the most bang forthe buck. GA and SC veterans, call for free advise. John 706-394-2605

09/24/2019

Savannah River Site Retirees after one year of being enrolled in your retiree health plan, either a Medicare Advantage Part C or Medigap/Supplement you can now change and use a LOCAL health agent who specializes in Medicare coverage options. This is important for several reasons: Part C plans members- Georgia in 2020 a major carrier will no longer offer the national plan previously offered in the state- that means you have a Guaranteed Issue right to purchase a Medigap/Supplement plan or change Part C coverage. In South Carolina a new carrier will be offered in Aiken county. For Medigap/Supplement members all Plan A-F supplements must by law offer the same benefits, I can compare underwriting with several carriers and seek to get a lower premium and keep your HRA dollars in your account. If you physically want to meet with an agent and discuss options Raborn Insurance agents represent ALL Medicare Part C plans in our area and 20+ Medigap/supplement carriers. John Raborn 706.394.2605

09/18/2019

2020 Medicare Part D and Part C Options become available on October 1, 2019! I know of FOUR NEW Part C Medicare Advantage Plans in my local region. In many counties of GA and SC new options become available.
In January 2020 changes to Medigap/Supplement choices take effect. Do not allow confusion or frustration with so many changes impact your Annual Election Period. We offer free consultation services. Not only do I have fifteen years of service to Medicare clients, I am a Medicare beneficiary. FREE CONSULTATION with Raborn Insurance Associates: 706.394.2605, [email protected]

08/18/2019

Medicare Medical Savings Account (MSA) Plans | Medicare

A question for Medicare eligible individuals:
Do you understand how a Medicare MSA Plan works and how it is different from other Medicare Advantage plans? For Raborn Insurance Associates service areas (GA & SC) I suggest you begin your research.
"These plans are similar to Health Savings Account Plans outside of Medicare" These plans have 2 parts: High Deductible and a special type of savings account where the Medicare MSA plan deposits money into your account. (These statements are found in the Medicare article link below). To start the learning process, I’d suggest you focus on at least 4 points:
1.Savings Account - money can be used to cover your Part A and B charges and these charges count toward the plans annual deductible, the money can be used to cover other costs such as prescription co-pays but do NOT count toward the plan deductible, balances earns interest, at years end any balance remains in your account,
2.Health Coverage- like all other Medicare Advantage plans they must cover all Medicare Part A and B approved benefits. You will have coinsurance on preventative benefits, these charges count toward the plan deductible. 3.Network: unlike other Medicare Advantage plans, there is no additional network requirements. However, you will want to use “participating” Medicare providers. Non-participating providers can balance bill charges above the allowable Medicare rate. You are required to pay the excess charge and this amount does NOT count toward the deductible.
4.Part D prescription coverage is NOT included and you will need to select a stand-alone Part D plan.
If you want to receive more information on this coverage and you live in GA or SC reach out to me via email or phone: [email protected]. 706.394.2605
Link to Medicare article on MSA: https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-medical-savings-account-msa-plans

Medical Savings Account (MSA) Plans, a type of Medicare Advantage Plan, may cover Medicare services, extra benefits, but not prescriptions.