Raborn Insurance Associates (RIA)- a husband and wife team who specializes
in Medicare Advantage, Medicare Supplement, Prescription Drug Plans, Dental and Vision in Georgia and South
(2)
Final expense life policies can bring peace of mind. We offer multiple companies allowing us to offer you the lowest rates possible.
Operating as usual
TWO THOUGHTS:
1. AEP is over for Medicare members. Sadly, that will NOT stop the endless commercials, why? From January 1 to March 31, Medicare designates this time as OEP. Anyone with a Medicare Advantage Part C plan can make ONE change.
2. New to Part C or change your plan. You should receive your packet and card no more than a month after your application was submitted to CMS. Didn't receive it, call your agent.
Happy Thanksgiving to each of you!
Many times we will hear this over the next several days.
How it is RECEIVED will be mixed.
Our family as some of you had Covid bring disruption, and even death. At my age I have lived a full and blessed life. Just like you there have been bumps-some I created others were thrust upon me. I hope you will CHOOSE to be thankful. I know this choice will not remove the physical hurt but it certainly will allow us to look gratefully at the days ahead. Happy Thanksgiving.
With a Humana Medicare plan, you may have a reduced Part B premium
This may mean less of a deduction in your Social Security check. And you’ll get Humana benefits you’ll like. They may include:
• A personal home care assistant
• Prescription drug coverage, with 90-day mail order through Humana Pharmacy®*
• An over-the-counter medication allowance**
Call a licensed sales agent to learn about virtual meetings.
*Other pharmacies are available in our network.
**Available only through Humana’s mail-order pharmacy; always consult with your doctor or medical provider before taking over-the-counter medications.
United Health Care AARP Supplement members in the state of GA, here is the latest.
Starting 1/1/21, everyone who enrolled 06/01/2010 or after and have received the 5% multi-insured discount will notice the discount is increasing to 7%! Additionally, on 1/1 you can take advantage of a 30 to 40% discount on dental services using a Dentegra in-network provider. Use the following link to search for providers: https://www.dentegra.com/
Not a UHC AARP Supplement member? Call for a free quote.
John 706.394.2605
Dentegra brings quality, individual dental insurance to more people through innovative, affordable plan that is easy to purchase and simple to manage online.
If you’re eligible for Medicare, you could enroll in a Humana Medicare Advantage plan without prescription drug benefits—and keep your VA health and drug benefits.*
A Humana Honor® plan may be a good fit if you want to keep your VA health and drug coverage.* It may help you save money while enjoying extras you might not get through VA.
*Veterans may choose a Humana Honor® Medicare Advantage plan without prescription drug coverage to avoid possible conflicts with VA prescription drug benefits.
USAA and the USAA Logo are registered trademarks of the United Services Automobile Association. All rights reserved. USAA means United Services Automobile Association and its affiliates. Use of the term “USAA member” or “USAA membership” refers to membership in USAA Membership Services and does not convey any legal or ownership rights in USAA. Restrictions apply and are subject to change.
Smile more, spend less Humana may help you get the dental care you need while saving money. Dental care is an important part of your overall health—and so is household budgeting. We take it all into account. Learn about the plan and everything it covers.
We have a plan for you. Are you eligible for both Medicaid and Medicare? We offer special Medicare Advantage plans for people who qualify and are designed to meet your needs.
Medicare has released the specifics for 2021.
Part A (hospital) 60 day benefit deductible $1,484
Days 61-90 $372 a day
Days 91 and beyond $742 (60 lifetime reserve days)
Part B (Medical) annual deductible $203
The Part B base premium $148.50
As posted earlier Social Security announced a Cost of Living increase of 1.3 for 2021.
Does Part D Gap or donut hole prices on your prescription cause you to cringe this time of year? If you have your Medicare coverage through a Part C Medicare Advantage and you enter the Gap then I'd encourage you to call me to discuss plan options.
Individuals with Medicare due to disability:
I assisted an individual who continued coverage under the spouse group major medical insurance as well as Medicare. He will drop the group coverage, changed to a Medicare Advantage Part C and saved over $10K a year in health insurance premiums. Depending on health premiums, prescriptions, providers, this may or may not be the right step. I will do a free evaluation to help you access costs and benefits.
John Raborn 706.394.2605
Social Security cost of living increase for 2021 is 1.3%. I am uncertain about the final Part B premium for 2021. Part B is funded by premiums 25% we pay and 75% from the Federal Government revenue. In April it was forecasted the premium would be $153.30. However, this past Wednesday the Senate submitted and President Trump signed the bill to cap increases to Part B premium at 25% of the increase.
Diabetics ensure to connect with your agent to review your 2021 coverage. AEP is 10/15-12/7. A number of Part D and Part C plans offer the Senior Savings Program with copays on insulin capped at $35 a month all year. That is significant savings.
There are new Part C diabetic plans for 2021.
Individuals with End Stage Renal disease can now enroll in Part C coverage for 2021.
If you know someone with Medicare and Medicaid, they need to review their options with me. The additional benefits offered by carriers: dental, vision, over the counter item, is significant.
RIA represents all traditional and most Special Needs Part C plans offered in the CSRA.
John 706.394.2605
Very interesting article on treatment for Parkinson's from the Charlotte Observer:
https://www.charlotteobserver.com/charlottefive/c5-wellness/article246227745.html?utm_campaign=KHN%3A%20Daily%20Health%20Policy%20Report&utm_medium=email&_hsmi=96778722&_hsenc=p2ANqtz-9tCLjq-V8lT-STivQOBbhVSm2OFSDuuGgfSayEScZfD4xwo3t7WzQXXMKQl0eCDTLVxBV6hXLHJ4vCiQFdDjbRaD-SZQ&utm_content=96778722&utm_source=hs_email
Hours after the center’s first procedure, Larry Hicks walked out to head home — and he can now hold a cup of coffee, brush his teeth, use a screwdriver.
Medicare members, financial planners, please share with your friends so you can help get the word out.
The Medicare website has the 2021 choices available. If you chose a Medicare Advantage Part C as your option and DO NOT have a local agent, then I encourage you to call me, 706.394.2605.
HOWEVER, only call IF you are willing to invest the time so I can assure I understand your personal needs: the providers you consider a MUST in network, prescriptions, maybe specific concerns-lower doctor copay, dental. In the local counties where I live there are 32 Part C plans in GA and this year 30 in SC NOT including Special Needs plans for Chronic conditions and Full Medicaid members! I represent ALL these carriers.
Sincerely, John. I have represented the Part C options since there inception in 2005.
To all my clients; NEVER ACCEPT A CALL FROM SOMEONE CLAIMING TO REPRESENT SOCIAL SECURITY. Fortunately a client tagged me in a 3 way call. "SS" was calling from El Paso Tx, to state that he had been charged with fraudulent activity, gave a case number and warrant number. When I interrupted because I did not want to stay on for an hour, I said the words Scam/Fraud and they immediately hung up.
These scams are real. DO NOT give any personal information over the phone. The US Agencies will contact you via mail.
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.
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.
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.
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.
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.
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.
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]
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.
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