Delaying Medicare Part B is a decision to not take lightly…

Did you know that if your employer group plan is small, delaying the Part B enrollment could create a penalty?
When you are eligible for Medicare usually at 65 you are required to maintain creditable coverage or enroll into the Medicare program with parts A, B, & D. In most situations employer group is considered creditable and you can delay the enrollment and stay on the group plan, but not always.
You may want to wait to sign up for Medicare Part A (hospital service) and/or Part B (outpatient medical services) if you are working for Medicare-cardan employer with more than 20 employees when you turn 65, and have healthcare coverage through your job or union, or through your spouse’s job. COBRA is not considered employer group coverage.
*If you are disabled under 65 and working (or you have coverage from a working family member), the Special Enrollment Period rules also apply as long as the employer has more than 100 employees.
When deciding to delay your Medicare enrollment it is important to determine if you will qualify for Special Enrollment Period (SEP).
You can get a Special Enrollment Period to sign up for Parts A and/or B:
• Any time you are still covered by the employer or union group health plan through your or your spouse’s current or active employment, OR
• Within 8 months following the month the employer or union group health plan coverage ends or when the employment ends (whichever is first).
If you wait longer, you may have to pay a penalty when you join.
When in doubt it is important to schedule an appointment with the local social security office and have them assist you in making the best decision for you.

Stay local it really matters

Don’t Be Scared… we’ve got you! Health insurance can be overwhelming and scary at times.  There are plenty of commercials, online ads and even people that go door to door.  Many times these situations use scare tactics, trying to push you towards a provider or plan that may not be your best option.  Never be afraid to say “no” or feel like you have to provide personal information to someone you are not comfortable with.

While there is a lot of informatio1505327765649n available to consumers, it can be difficult to interpret.  There is no need to feel intimidated; this is where your local agent can help you.  An agent should be there for you, to educate you on your options, help with issues and give you peace of mind; not only the day of your appointment but for years ahead.

Whether you have a simple question, or would like to stop by for an appointment please feel free to call our office 920-544-0058!  We are here to help you.

 

What is a silent tax return in regards to compliance with the individual mandate provisions of the Affordable Care Act (ACA)?

What is a silent tax return in regards to compliance with the individual mandate provisions of the Affordable Care Act (ACA)?

Here is the information from the IRS website. Sited below. “This in not tax advise only a resource to answer questions for clients whom choose to use non-ACA compliant plans.”

ACA Executive Order and Current Tax Filing Season

The IRS is currently reviewing the Jan. 20, 2017, executive order to determine the implications. Taxpayers should continue to file their tax returns as they normally would.

The instruction for individual taxpayers involving the Affordable Care Act has been to indicate on their Form 1040 filing whether they had health insurance, an exemption from coverage or made a shared responsibility payment. In recent years, tax returns silent in that regard were still processed. This year, the IRS put in place system changes that would reject tax returns during processing in instances where the taxpayer didn’t provide that information.

The recent executive order directed federal agencies to exercise authority and discretion available to them to reduce potential burden.‎ Consistent with that, the IRS has decided to make changes that would continue to allow electronic and paper returns to be accepted for processing in instances where a taxpayer doesn’t indicate their coverage status.

However, legislative provisions of the ACA law are still in force until changed by the Congress, and taxpayers remain required to follow the law and pay what they may owe‎.

Processing silent returns means that taxpayer returns are not systemically rejected by the IRS at the time of filing, allowing the returns to be processed and minimizing burden on taxpayers, including those expecting a refund. When the IRS has questions about a tax return, taxpayers may receive follow-up questions and correspondence at a future date, after the filing process is completed‎. This is similar to how we handled this in previous years, and this reflects the normal IRS post-filing compliance procedures that we follow.

At the below link you can read the full story and have access to links for:

  • Individuals
  • Businesses
  • Reporting requirements
  • Payroll clients
  • General resources

https://www.irs.gov/…/aca-information-center-for-tax-profes…

July 28, 2017 – updates regarding individual insurance

I promised you that as updates happened to the Affordable Care Act that I would give you a clear concise analysis of what the updates are and how they apply to you. Last night’s vote in the Senate did nothing to the current law of the land. The law does however have some issues that are coming up. One of the issues is the expiration of funding for the subsidies19508354_s used to assist people with the high deductibles and coinsurance when they have a lower income, defined as at or below 250% of the federal poverty level. These payments to the insurers are scheduled to stop this year. Insurers are obligated by the Affordable Care Act to grant the subsidies, known as cost-sharing reductions, to eligible customers. At this point, failure to address this issue is expected to increase premiums for individual coverage 15 – 30% for 20181. Currently companies offering individual plans have filed rates with the commissioner with the prediction that these payments will stop and have a chance to change the rate before the plans are actually set to release. I, like you, will be waiting for the November 1st release date to actually see the rates.

The state of Wisconsin could do something to help reduce the price hikes for premiums for Wisconsinites. The state could apply for at 13:32 waiver and set up a program to help with the very ill. This waiver is what the state did to keep the BadgerCare plus program for children under 193.

Currently approximately 20% of the population creates 80% of the health care costs in this county 4. If the state were to create this waiver they could in act an underlying program that helped the insurance carriers mitigate the costs to consumers while working with providers to manage this specific populations cost in a more cost effective and innovative manner much like the HIRSP of old 5.

The time is now for them to act but I have heard nothing. I also have heard no mention of cost control or requiring providers of healthcare to disclose prices so consumers are aware and can shop if they want to. I have seen more and more difficulty trying to determining pricing before procedures and no transparency. Please be aware many hospitals will not send out detailed billing unless you specifically request it.

To date companies that offer individual insurance in Wisconsin have reported large losses. If there are any winners with the ACA it is not the insurance companies. The only ones seeing record profits are the hospital systems 6. Anthem Blue Cross has decided to stop offering individual coverage in Wisconsin except for in one smaller County. Wisconsin now only has 13 companies statewide that will be selling individual plans 2. Remember plans are regional and in most counties you may have 2 or 3 carrier options. In some counties like Kewaunee you will only have one company in others it is rumored that there might be no options. People often come to me and say, “Well I will just go off the marketplace and buy a plan.” What people fail to grasp is that if they are not selling… they are not selling…. There is no magic plan that I can find for you.

The options today are:

  • ACA Compliant coverage (true health insurance regulated by the Commissioner of Insurance with no cap on coverage and no underwriting)
  • Short term (underwritten, 91 days at a time.) Changes to this option have made it difficult to use and not appropriate for most consumers.
  • Alternative plans (They are out there and they are underwritten. They are often called Christian plans but buyers beware as they are not regulated by the Commissioner of insurance – much like banking without FDIC protections.)
  • Indemnity plans ( This is often toted as an option but read the fine print as they really just pay you directly a small portion of what the bill actually is. You may still have huge medical bills)

 

  1. http://www.cnbc.com/2017/05/19/trump-reportedly-wants-to-kill-critical-obamacare-subsidies-despite-warnings-health-insurance-premiums-would-spike.html
  2. http://www.kff.org/health-reform/issue-brief/insurer-participation-on-aca-marketplaces-2014-2017/
  3. https://www.dhs.wisconsin.gov/dhcaa/memos/13-32.pdf
  4. http://www.politifact.com/oregon/statements/2012/feb/23/alan-bates/does-20-percent-population-really-use-80-health-ca/
  5. http://echealthinsurance.com/wisconsin-health-insurance/public-assistance/health-insurance-risk-sharing-plan/
  6. https://www.forbes.com/sites/brucejapsen/2015/03/01/hospital-profits-soar-as-obamacare-prescribes-more-paying-patients/#68a07da74da9

 

 

New Rules for Medicare Cards on the Horizon

Medicare Card

Effective April 2018 Medicare will start sending new Medicare Cards. Medicare will no longer use the Social Security number on your Medicare card.  With feedback from providers and the spike in identity theft, Medicare has decided that it makes sense to change the current practice. With the passage of MACRA “Medicare Access and Children’s Health Insurance Program Re-authorization ACT of 2015” the changes will be phased in over a from April 2018 to December 31, 2019.

The new cards will have a randomly generated Medicare Beneficiary Identifier. They will be 11 characters long and be a mixture of numbers and upper case letters.

 

Calcium Score…do you know yours?

Heart disease continues to be the number one killer of both men and women. But when found early, heart disease can be treated and oftentimes reversed.

What is heart calcium scoring?

Heart calcium scoring is a screening test that can help reveal heart disease in its early stages, even years before you have a symptom. The test is fast, pain free and safe. There are no needles or dyes. It’s similar in many ways to receiving an x-ray. Yet the results can help save your life.

Who can benefit most?

In general, if you are a man over 30 or a woman over 40, or if you have the following risk  factors, you should consider having a heart calcium scoring:

¨ High cholesterol levelsheart health

¨ Family history of heart disease

¨ Diabetes

¨ High blood pressure

¨ Cigarette smoking

¨ Overweight or obese

¨ Physically inactive

 

This test is offered to you by most of our local area hospitals. Currently most insurance plans are not covering this screening  and that goes for Medicare too.  But it is very affordable. The test costs you about $50.00. Some do charge more so don’t be afraid to shop around.

 

Did you know??

The Wisconsin Department of Health Services has advanced directive forms available online. These forms are designed to be completed without the assistance of an attorney. Given your particulardownload 2 circumstances or concerns, however, you may want to seek legal advice from an attorney. The forms available are:

¨ Declaration to Physicians (Wisconsin Living Will)

¨ Power of Attorney for Health Care

¨ Power of Attorney for Finance and Property

¨ Authorization for Final Disposition

These forms, or variations of these forms, may also be available from your attorney, physician or hospital.

Multi-language versions of the Advance Directive and Power of Attorney for Health Care may be obtained by the following source: Aging with Dignity (link is external).

https://www.dhs.wisconsin.gov/forms/advdirectives/index.htm

 

 

 

Seed, Seeds, Seeds.. part one

You might want to consider growing your diet in a new way. Seeds! Seeds offer a lot of benefit and are often over looked. This time I am featuring CHIA seeds. Don’t be fooled by the size… these tiny seeds pack a powerful nutritional punch.

To Ten List for CHIA seeds!chia seeds

  1. Chia Seeds Deliver a Massive Amount of Nutrients With Very Few Calories.
  2. Chia Seeds Are Loaded With Antioxidants
  3. Almost All The Carbs in Them Are Fiber
  4. Chia Seeds Are High in Quality Protein
  5. Due to The High Fiber and Protein Content, Chia Seeds Should be Able to Help You Lose Weight
  6. Chia Seeds Are High in Omega-3 Fatty Acids
  7. Chia Seeds May Improve Certain Blood Markers, Which Should Lower The Risk of Heart Disease and Type 2 Diabetes
  8. They Are High in Many Important Bone Nutrients
  9. Chia Seeds Can Cause Major Improvements inType 2 Diabetics
  10. Chia Seeds Can Improve Exercise Performance as Much as a Sports Drink

A 1 ounce (28 grams) serving of chia seeds contains:

* Fiber: 11 grams.

* Protein: 4 grams.

* Fat: 9 grams (5 of which are Omega-3s).

* Calcium: 18% of the RDA.

* Manganese: 30% of the RDA.

* Magnesium: 30% of the RDA.

* Phosphorus: 27% of the RDA.

They also contain a decent amount of Zinc, Vitamin B3 (Niacin), Potassium, Vitamin B1 (Thiamine) and Vitamin B2.

read more about it:   https://authoritynutrition.com/11-proven-health-benefits-of-chia-seeds/

 

Discount Prescription Drug Cards

Discount prescription drug cards can save you money. But, some scammers use fake discount cards to steal your identity or your money. Before accepting discount cards remember:

  • REAL discount cards are Free—you should never pay for one
  • FAKE discount cards ask for money or claim to replace Medicare
  • TALK to someone you trust, like your agent, health plan provider or pharmacistdiscount card

Good prescription discount cards:

  • Are free and may come from well-known stores or healthcare companies
  • Can help Medicare D enrollees in a coverage gap or an individual during the deductible. Make sure they file the claim with your plan first.
  • Do not claim to replace Medicare or insurance

Avoid cards that:

  • Ask for money, your Medicare number, any insurance member numbers or banking information
  • Claim you will lose your Medicare or Prescription drug coverage without a card.

If you enrolled in Medicare part D you can always call 1-800-Medicare with questions about your prescription drug costs and any gaps in coverage.

Information, education and product knowledge are the cornerstones of great agents and we want to be your health insurance agents!  Call Diane at Woodhead Insurance Services LLC 544-0058

 

 

 

What is a drug formulary and why do I care?

A drug formulary is a list of prescription drugs, both generic and brand name that are covered by your plan. doc pills choiceA committee of physicians, nurse practitioners, and pharmacists maintain the formulary and the medications are chosen for their safety and effectiveness. Clinical expertise and input is also sought from many other local physicians who are not committee members. The formulary, pre-service authorization parameters, and related procedures are updated as needed when new information becomes available.

So now you know what it is …. Why should you care? People in the United States spend almost $1,000 per person per year on pharmaceuticals. When you think about it… that is a staggering number and you do have some control of what your share of that amount is. Here is where you should begin:

  • Make sure your current medications are covered by your plan. At your annual review make sure your agent is reviewing your medications with you. We are human and can forget so don’t let us! There are new rules and restrictions all the time as insurance companies are struggling with the cost of these medications.
  • Does the manufacturer offer you discounts? Or if you are on Medicare, are you eligible for Senior Care of Wisconsin or other programs? High cost does not necessary get passed fully to the consumer. There are programs out there that are designed to make Pharmacymedications more affordable. But if you don’t ask, you don’t benefit. Have your agent do some research or ask your pharmacist. They know of programs and discounts and are just waiting for you to ask!
  •  Be your own best advocate! When you go in for your annual doctor visit don’t be afraid to bring a copy of your formulary. Doctors often do not know the price you pay for your medications but do have a lot of choices in what they prescribe. Look up your current medications before going and speak up! He or she needs to hear what you want and then they can help you to make a decision that is not only the best for your health, but also friendlier on your wallet.
  • New prescriptions Some doctors are quick to write a prescription, but then hesitant to stop a medication. Make sure you do your research and ask lots of questions about long term health goals. If you are asking the questions and the doctor doesn’t give you the answers you deserve, then you may want to look at switching doctors. If you are starting a medication that you will have to take for the rest of your life, you are making a BIG investment. Don’t make it lightly!

    Information, education and product knowledge are the cornerstones of great agents and we want to be your health insurance agents!  Call Diane at Woodhead Insurance Services LLC 544-0058