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Avoid the Top 5 Mistakes People Make on Medicare

Join our workshop to learn about the common mistakes people make on Medicare and how to avoid them. Presented by Doug Lubenow, President of Senior Advisors. Contact us for more information.

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Avoid the Top 5 Mistakes People Make on Medicare

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  1. Medicare Workshop Avoid the Top 5 Mistakes People Make on Medicare Presented by: www.senior-advisors.com info@senior-advisors.com Doug Lubenow, RHU, CLTC President Prior Member of Medicare Advisory Board for National Association of Health Underwriters Justin Lubenow Medicare Specialist Medicare Advisory Board for National Association of Health Underwriters 856.866.8900 214 W. Main St Suite 101 Moorestown, NJ 08057 908.272.1970 15 Alden Street, Suite 8 Cranford, NJ 07016 - 1Q 2019-

  2. Parts of Medicare • Inpatient care in hospitals • Skilled nursing facility, hospice, and home health care Usually, no premiums premium • Another way to get benefits covered under Part A & B • Most offer prescription drug coverage (part D) • Run by private insurance companies Varies by plan • Doctors, hospital outpatient care, durable medical equipment and home health care • Preventative services Usually, $135.50/mo.* * Income adjusted • Helps cover prescription costs • Run by private insurance companies Usually, plan premium* * Income adjusted

  3. Medicare Part B: Monthly Premiums 1 Income is based on prior full year tax return (e.g. 2016 MAGI for 2018 premiums; 2017 MAGI for 2019 premiums)

  4. Medicare Part D: Monthly Premiums 1 Income is based on prior full year tax return (e.g. 2016 MAGI for 2018 premiums; 2017 MAGI for 2019 premiums)

  5. Medicare B & IRMAA* TOTAL Monthly Premiums * Income Related Monthly Adjustment Amounts 1 Income is based on prior full year tax return (e.g. 2016 MAGI for 2018 premiums; 2017 MAGI for 2019 premiums)

  6. 1 Initial Enrollment Period • 7-month Initial Enrollment Period (IEP) • Eligible 1st of the month turn 65* • Critical to enroll during the 7-month IEP • Can enroll later with penalties (10% per year) IEP Example * If your birthday is 1st of the month, you are eligible the previous month

  7. Medicare Choices at a glance START STEP 1: Decide how you want to get your coverage. ORIGINAL MEDICARE MEDICARE ADVANTAGE Part C (like an HMO or PPO) Part B Medical Insurance Part A Hospital Insurance Part C Combines Part A, Part B, and usually Part D STEP 2: Decide if you need to add drug coverage. Part D Prescription Drug Coverage END STEP 3: Decide if you need to add supplemental coverage. Medicare Supplement Insurance (Medigap) policy If you join a Medicare Advantage Plan, you can’t use and can’t be sold a Medicare Supplement Insurance (Medigap) policy. END

  8. Original Medicare compared to Advantage 3

  9. Plan F Example – Part A 2019

  10. Plan F Example – Part B 2019

  11. Plan F Example – Part A & B 2019

  12. Plan G Example 2019 • Plan G is the same as Plan F, except for the Part B deductible

  13. Plan N Example 2019 • Plan N is the same as Plan G, except for doctor copays and Excess Charges

  14. Medigap Open Enrollment • 6-month Open Enrollment Period* • You may be eligible for Open Enrollment… • Up to 6 Months after your Medicare Part B effective date • …if you were previously covered under Medicare (SS Disability) and you turn 65, you have another 6-month open enrollment period * Guaranteed Issue: Will not need to answer health questions (no medical underwriting)

  15. * Changes in Bipartisan Budget Act of 2018 Medicare Part D: Prescription Coverage 2019 Strikethrough: 2018 values Orange Text: 2019 Changes LEGEND >$5,000 >$5,100* *based on Tro-oP Who Pays What? <$5,000 <$5,100 *based on Tro-oP • Member pays a little • Plan pays most <$3,750 <$3,820 *based on retail costs • Member pays MOST • Plan pays a little up to… $405 $415 • Member pays part • Plan pays part • Member pays all • Plan pays nothing Pharma Discount for brand name drugs: 50% 70%* 35%25%* of Brand-Name Drugs 44%37% of Generic Drugs The greater of 5% or $8.35$8.50(Brand-Name) $3.35$3.40 (Generic) TOTAL COST OF DRUGS Many plans have $0 deducible. COPAYS or COINSURANCE MEMBER PAYS:

  16. Part D Examples on Medicare.gov Example 1 • Zip 08054 • Drug List ID: 3134985216 • Date: 10/15/2017 Metformin Example: • Zip: 07849 • Drug List ID: 7790380192 • Date: 07/07/2017

  17. Medicare Workshop Avoid the Top 5 Mistakes People Make on Medicare Presented by: www.senior-advisors.com info@senior-advisors.com Doug Lubenow, RHU, CLTC President Prior Member of Medicare Advisory Board for National Association of Health Underwriters Justin Lubenow Medicare Specialist Medicare Advisory Board for National Association of Health Underwriters 856.866.8900 214 W. Main St Suite 101 Moorestown, NJ 08057 908.272.1970 15 Alden Street, Suite 8 Cranford, NJ 07016 - 1Q 2019-

  18. APPENDIX

  19. Who …we are Our top priority is to reduce stress for Medicare beneficiaries, by providing education, an overview of the choices available, and making recommendations for each individual's coverage. • Founded in 2009 • Over 20,000 Medicare Clients Nationwide • President is Doug Lubenow; ~30 years in Insurance Industry • Family Owned & Operated • All 5 star reviews - https://www.senior-advisors.com/testimonials.html • Member of the Medicare Advisory Board of National Association of Health Underwriters (NAHU) from 2012-2016 https://www.senior-advisors.com/about-us.html READ THIS FOR MORE INFO

  20. Who …we are Our top priority is to reduce stress for Medicare beneficiaries, by providing education, an overview of the choices available, and making recommendations for each individual's coverage. • Rutgers Business School, B.S. Management Science & • Information Systems (MSIS) • Master’s Degree, MIS, Stevens Institute of Technology • 15 years in “Corporate America” – Account Director for Several Software Companies managing accounts AT&T, Verizon, Citi, AMEX, and more! • Joined Senior Advisors in June 2015 and opened the office in Cranford • Member of the Medicare Advisory Board of National Association of Health Underwriters (NAHU) since 2016 https://www.senior-advisors.com/about-us.html READ THIS FOR MORE INFO

  21. Where…we are We have two offices in NJ, and we are licensed in 25+ states. Cranford Office 15 Alden Street, Suite 8 Cranford, NJ 07016 Moorestown Office 214 W Main Street Suite 101 Moorestown, NJ 08057

  22. Where…we are We have two offices in NJ, and we are licensed in 25+ states.

  23. What…we do Educate seniors on Medicare, provide options for coverage, and help them enroll. Assist with Enrollment Provide Options Educate • Part A (Hospital) • Part B (Doctors) • Medigap Plans (aka Medicare Supplement Plans) • Medicare Advantage • Part D (RX Plans) We offer FREE workshops: What Baby Boomers need to know about Medicare. https://www.senior-advisors.com/watch-workshop-now.html And More!

  24. Who Pays First??? • There are several situations where knowing who pays first is extremely important, as it may cause employees claims to not be paid or for them to face penalties at a later date.

  25. Part B Enrollment Scenarios *Social Security • Turning 65 (already enrolled in SS*) • Auto-enrolled in A & B • Turning 65 (not enrolled in SS*) • Enroll online at https://secure.ssa.gov/iClaim/rib • Enrolling after age 65 (see next slide)

  26. Enrolling After Age 65 Two forms needed to drop at Social Security Proof of Coverage Formhttps://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf Enroll in Part B Formhttps://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf

  27. Medicare Supplement Plans Overview Illustrative Diagram The following examples will focus on plans F, G, & N F ~3% of 2018 policies* Premium G ~78% of 2018 policies* N ~13% of 2018 policies* * Policies enrolled by Senior Advisors Level of Coverage

  28. H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015

  29. Supplemental Guaranteed Issue When are Supplemental Guaranteed Issue Periods?No Medical Questions

  30. 2 RX Card A Example Monthly Premium: $98.30 Annual Drug Deductible: $0 Total Annual Cost: $4,796.41

  31. RX Card B Example Monthly Premium: $39.20 Annual Drug Deductible: $0 Total Annual Cost: $12,799.48 *not covered on Formulary

  32. RX Card C Example Monthly Premium: $97.00 Annual Drug Deductible: $325.00 Total Annual Cost: $16,256.69 *not covered on Formulary

  33. 5 RX Comparison *Card A and B are the same company

  34. Not enrolling in Part B on-time 1 • Initial Enrollment Period • 10% Penalty/year • COBRA • Retiree Plans • Social Security Disability

  35. Not analyzing prescription drugs 2 • Could cost you thousands of $$ • 30 different drug cards • Formularies are key • Medicare.gov • Annual Enrollment 10/15 to 12/7

  36. Medicare Advantage vsMedigap 3 • Networks & Referrals • Max. Out of Pocket Expense • Changes during Annual Enrollment • Extra Benefits • Overall expenses

  37. Not analyzing retiree coverage 4 • Premiums • Co-Pays • Co-Insurance • Compare all-in expenses

  38. Listening to Friends & Family 5 • Drug Cards • Advertisements • Analyze entire expense (not just prem.) • Association Plans (not guar. renewable)

  39. OTHER RESOURCES AVAILABLE Follow us on Facebook 20+ short videos available Weekly updates ~25 Instructional videos on Medicare ~90 min. Medicare workshop video FREE Part D Analysis Form Blog Articles monthly Get Quotes & More! www.senior-advisors.com

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