Original Content From Senior Benefit Services, Inc.
SBS blog is a compilations of all Senior Benefit Services Blogs posted over the years. These blog vary in topic from tech help, productivity, to selling opportunities and other related insurance needs. Scroll through to check out our blogs and discover something new!
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Thoughts From Senior Benefit Services, Inc.’s President: David Kurtz
Welcome to 2022!
Does anyone else think that 2021 went fast? It seems like I was just writing about how we would all be looking forward to putting 2020 in the history books and welcoming in 2021. Like most folks we have hopes of gaining back a little bit more normalcy and enjoying a little less stress in our lives.
I have been asked quite a bit about time management and all sorts of other ways to reduce stress in our business. To say there are too many things to learn in a couple of days would be an understatement. There have been thousands of books written on this topic alone, so I will share just a few things that I practice that may or may not help you reduce some stress during 2022.
Top 5 Stress Relievers
Wake up and be grateful.
No, I am not trying to be holistic here and recruit you into a cult. Too many times people wake up and immediately start thinking about what they need to get done today. This starts your morning off with an inner stress that will continue for the rest of the day. Think I am wrong? When is the last time that you had a morning argument with someone and then immediately had a great day after that? Instead, our brains keep thinking about the argument even though we would rather forget that it even happened. When the alarm goes off in the morning, just try to lay there for 2 minutes and think about the great things in your life. The biggest one is that you are alive! There will come a day that we won’t have that next morning, so don’t take it for granted. Have a happy marriage?…. then look over at your spouse and smile. Are there children in your life, then think about how they make you feel and the additional purpose they give you in succeeding. Do not wake up and immediately check your email or turn on the talking heads (those folks who sit in front of a camera and give their negative opinions instead of the actual news). Most importantly, never start your morning off by reading social media! Besides social media being the biggest time waster, it has been scientifically proven to depress people because they think that other people’s lives are so great and that their life is not. Social media is the biggest Book of Fairy Tales that you will ever read.
Ditch the To-Do List!
I’m not saying that all lists don’t work. I still use a grocery list and a weekend list of things I need to do around the house. Using a To-Do List in business is not very efficient. Most people in business who try using a To-Do List will tackle the easier things on the list first since they can be done quickly. It also gives you that sense of accomplishing something…even if its just busy work. It is better to schedule things on your calendar. An example of this would be the desire to tackle your overload of emails, contacting 5 existing clients about life insurance, and still running your appointments. Why will 100% of our appointments be seen? They are on our calendar! If we schedule the other things that we need to get done on our calendar, they will get done as well. It really is that simple.
Stop trying to remember everything!
I can actually forget something that I was planning on doing within 5 minutes after thinking about it. My wife and children say its due to me getting older, but in reality it was me getting busier over the years. The more we have hit our plate or get distracted by, we simply forget quicker about things. To keep this from happening I have more options available to me today than 30 years ago. With my iPhone I can simply tell Siri to put something on my calendar or schedule a reminder when I think of something I need to get done. By doing this, I immediately reduce my stress levels and guarantee that it will get handled. Have a phone that uses Android, then use Google Assistant to accomplish the same thing.
Invest in Yourself!
While we are adding things to our calendar, how about schedule some time to invest in yourself instead of big companies. At night instead of supporting Netflix or networks such as NBC, CBS, and ABC…read a book that can help you improve yourself. You will get more out of reading Eat That Frog by Brian Tracy than watching something mind numbing on the television. I know agents who make it a point to read an outline of coverage on a particular product each day to get them better familiar with exactly how it works. This gives them more confidence in presenting the product and with additional knowledge, we reduce the stress of trying to wing it during an appointment.
Stop Worrying About Things!
Did you know that over 99% of the things we worry about never happen? Our mind can be our own worst enemy. Since bad news sells, it is going to be everywhere. Don’t let things that haven’t happened take up space in your mind rent free. Time continues to move forward whether you are happy or not. When I was young, I used to think that at age 50 my life would be half-way over. Boy was I naïve! Years back when I turned 50 I realized that if I were to live to age 79 (one year longer than my father), then I had already used 18,250 days up and only had 10,585 days left. You only have one life, so enjoy it.
We truly hope that 2022 will be filled with happiness, productivity and overall success for each and everyone one of you. Thank you for the trust you place in our company year after year.
It’s hard to believe that we’re in the final 2 months of 2021! Finish the quarter and the year strong by offering additional coverage to your clients like a Hospital Indemnity plan or Dental Vision & Hearing coverage. These products offer benefits that help your clients cover potential out of pocket costs with multiple benefit options to fit any budget. Continue Reading below for more details on what plan options we have available.
Every year we get questions about selling Medicare Advantage from a lot of “non-Medicare Advantage agents”. So I’ve decided to focus on a Medicare Advantage blog series that will address a lot of the questions our Marketing Department receives about Part C (That’s Medicare Advantage, you know).
What is Medicare Advantage?
Established in 2003, Medicare Advantage is an alternative option to Original Medicare where it pays for health care costs based on a monthly fee per enrollee rather than billing for each fee for a Medicare services that is provided to the client. (like Original Medicare). But for an actual definition we turn to www.Medicare.gov (the most useful website you should probably have bookmarked),
“Medicare Advantage Plans, sometimes called ‘Part C’ or ‘MA Plans’ are offered by private companies approved by Medicare.” When a client joins a Medicare Advantage plan, they still have Medicare, but not original Medicare Part A (hospital insurance) and Part B (Medical Insurance). The client instead receives coverage from Part C (Medicare Advantage Plan) that typically includes a Rx plan.”
The definition is pretty straight forward, instead of the client receiving Original Medicare they will have Medicare under Part C.
What Carriers Offer Part C?
There are quite a few carriers that offer Medicare Advantage, but the carriers we focus on are Aetna, Humana, and Johns Hopkins (MD only). These are private companies that have a contract with Medicare offering a couple different types of Medicare Advantage plans.
There are different types of Medicare Advantage Plans?
I know it’s confusing because there appears to be one Original Medicare so you would think there is one Medicare Advantage plan. However there are 4 common Medicare Advantage plans that you will see most often:
- HMO – Health Maintenance Organization plans are typically the most affordable (and sometimes with a $0 premium) but the client will have to go to doctors, hospitals, and specialists within the plan’s network.
- PPO – Preferred Provider Organization will cost more but allows your client to go to doctors, hospitals, and specialists out of the plan’s network. Of course, going outside of the network will come at a higher cost rather than staying within the network.
- PFFs – Private Fee For Services is very similar to Original Medicare where the client can go to any doctor, hospital, or specialist as long as they accept the plan’s predetermined costs for care.
- SNPs– Special Needs Plans focus on specialized health care for clients that have both Medicare and Medicaid (also called a Dual Eligible), living in a nursing home, or have chronic medical conditions.
With the carriers we work with, you will find that HMOs and PPOs are the most common Medicare Advantage plans.
What’s the cost of a Medicare Advantage plan?
Your client’s Medicare Advantage premium can vary from carrier to carrier and by state. Typically there is a monthly fee associated with the commonly sold HMO and PPO plans that is in addition to the Part B premium. Even though your client will not be receiving the benefits of Original Part A and Part B of Medicare they still will need to pay their Part B (Medical Insurance) premium.
Who Can Enroll in a Medicare Advantage Plan?
Any client that has Part A and B and lives in the plan’s service area. There is no underwriting except clients with End-Stage Renal Disease (ESRD), who typically cannot purchase a Medicare Advantage plan.
What’s the difference between Original Medicare and Medicare Advantage?
When you get right down to it, there’s not much of a difference. Both offer the same services, however Medicare Advantage is through a private company and the out of pocket costs can differ. In addition, there are details to both Medicare options that can make a big difference for the client. The Medicare Rights Center created a neat guide to help explain the difference. Click Here for the original copy or check out the details below:
- The traditional program administered directly through the federal government.
- Includes Part A (hospital) and Part B (medical) coverage if you enroll in both.
- You pay a deductible and/or coinsurance when you get health care (usually 20% of the Medicare-approved cost for outpatient care).
- Most people pay a monthly premium for Part B. There’s no Part A premium if you have at least 10 years of United States work history.
- You can go to any doctor or hospital in the country that accepts Medicare.
- No referrals needed to see specialists; no prior authorization for services.
- You can buy a Medigap plan as supplemental coverage.
- If you want Medicare drug coverage, you must buy a separate Prescription Drug Plan (PDP) from a private insurance company
- Sold by private insurance companies that provide Medicare benefits.
- Must cover the same Part A and Part B benefits as Original Medicare.
- Some also cover extra benefits such as vision and dental care.
- The most common types are HMOs (Health Maintenance Organizations), PPOs (Preferred Provider Organizations) and PFFS (Private-Fee-for-Service) plans.
- You still have Medicare but you’re no longer in Original Medicare—you’re in a private plan that typically has different costs and restrictions.
- You pay a deductible and/or copay for services (usually a fixed copay, like $15 per office visit).
- You still pay Medicare premiums, and your plan may charge an extra premium.
- You typically are required to use doctors and hospitals in the plan’s network.
- You may have to choose a Primary Care Physician, get referrals to see specialists, and/or get prior authorization for certain services.
- You can’t buy Medigap supplemental insurance to help pay your out-of-pocket costs.
- Plans must have yearly limits on your out-of-pocket health care costs (an out-of-pocket maximum), after which you pay nothing for the rest of the year.
- If you want Medicare drug coverage, sign up for a plan that includes both health and drug coverage, called a Medicare Advantage Prescription Drug Plan (MA-PD). You usually can’t have a separate Part D plan, unless you’re in a Medicare Medical Savings Account (MSA) or a PFFS plan.
Another thing to keep in mind is that hospice care falls under Original Medicare. However if a Medicare Advantage client requires hospice care then they will be able to use it under Original Medicare. If the client decides to drop their hospice care then they can return to the Medicare Advantage plan the following month.
What’s the downside to Medicare Advantage?
After comparing it to Original Medicare, Medicare Advantage doesn’t seem as bad as I originally thought. But what might work for one client, won’t work for them all. Here are some downsides for you and your client to consider.
One, the carrier is privately contracted by Medicare, which means if the carrier doesn’t renew the contract then members will lose coverage.
Two, depending on what type of Medicare Advantage plan the client enrolls in they might have to switch doctors and specialists. If they are not willing to do this, make sure you find a plan where their preferred doctors are within their network or at least a plan where they can travel outside of their network. Keep in mind networks can change from year to year. Speaking of the network, it’s important for clients to understand that if they travel or receive care outside of their “home” state, their plan may not cover that care (emergency care is often an exception). For us on the East Coast, there a lot of “Snow Birds” that spend their summers in a northern state, and their winters in the south. In situations like this they’ll want to ensure they have access to in network care when in a different state.
Another downside, is the Rx coverage in Medicare Advantage Plans. If you client is on a prescription medication make sure you check out what Tier Level their prescription falls under because pricing will vary from plan to plan. If you’re not too sure of the client’s prescription costs under Medicare Advantage then review everything under www.Medicare.gov’s Plan Finder. Here you can compare the out of pocket cost with a Medicare Advantage versus purchasing a Prescription Drug Plan (PDP) with Original Medicare. And just like the provider network, the Prescription formulary can change as well. So be sure your clients are reviewing plans annually to see how changes with their medications or changes to the plan’s formulary will impact their out of pocket costs.
Have any further questions?
If you have any further questions or comments about the basics of a Medicare Advantage, let me know in the comment section below. I’ll be happy to find out details for you.