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    What’s Next??

    Posted: January 12, 2022

    *Healthcare: Open Enrollment has been extended until January 15th.  Current policy holders can submit changes to their existing plan or submit a NEW plan.  Once the 15th has passed, you will not be able to make any plan changes.  NEW policies submitted during this time will take effect February 1st.

    *Medicare: Medicare Supplement policy holders ages 65-75 have the option to change to another Medicare Supplement plan without requiring underwriting approval.  To qualify for the Birthday Rule, you must enroll in a plan with the same or lesser benefits.  The change must be done within 45 days AFTER your birthday. 

    *Medicare: Medicare Advantage policy holders are currently in a second Open Enrollment period until March 31st.  During this time, you can change to another Medicare Advantage Plan.

    *Auto/Home Insurance: Many policies renew during the month of January.  When reviewing rates consider these tips:

    +Always review the total package (i.e. home and auto).  Often, some carriers will have a better rate on the home as opposed to the auto however, the total calculation needs to be reviewed when determining the best scenario. 

    +Make sure you are matching coverages.  Some carriers are notorious for removing full coverage to reduce the rate.  Sadly, some people do not realize that until they have an accident.  Full coverage means the carrier will fix your vehicle in the event of an at fault accident.  On the flip side, liability only means your vehicle is NOT getting fixed in the event of an at fault accident.

    *Life Insurance: With the start of the New Year, many will review their financial goals for the year and discuss any gaps.  Many people will not buy Life Insurance because they overestimate the cost of a policy. Costs depend on a number of factors, including your health, age, tobacco use, and gender.  As one example, a healthy 35-year-old male can expect to pay about $20 per month for $250,000 on a 30-year term.

    *Business Insurance: We’ve received LOTS of calls lately regarding employees injured on the job.  A workers compensation policy provides wage replacement and medical benefits to employees injured as a result of their job.  Premiums are based on the annual payroll and type of work performed.

    Medicare Open Enrollment October 15th-December 7th

    Posted: October 26, 2021

    Medicare Open Enrollment is happening NOW

    During this time, you can make changes to your prescription drug plan, enroll in a plan, change your Medicare Advantage Plan, or enroll in a Medicare Advantage Plan.

    If you have a Medicare Supplement Plan, you are not obligated to make changes at this time.  You can enroll in a Medicare Supplement at any time.  Please note, if you are interested in making a change outside of your initial enrollment period, Medicare Supplement plans are subject to underwriting.  This means you can be charged a higher rate or denied due to past medical history.

     

    TIPS to Reducing your Premium…

    *Consider a Medicare Advantage Plan.  If you are already in one, you may want to consider another carrier.  Be sure to pick a plan with a maximum out of pocket and confirm that your doctors accept the plan before switching.  This will protect you in the event of a “bad” year.  

    *Consider switching the type of Supplemental Plan you are in currently (i.e. Plan G is often less expensive than a Plan F).  I will caution, that changing your plan may require you to pay for services that you have not paid for in the past.  For example, a Plan N will charge the Part B deductible and $20 co-pay for doctors’ visits. 

    *Review your drug lists with other carriers.  Medicare.gov is a great source for reviewing rates with other carriers.  Simply plug in your drug information, select your pharmacy, and review the different plans available (based on the drugs you are taking).

    *Consider switching pharmacies.  First, watch to make sure your pharmacy is still in the Preferred Network with your prescription drug plan.  Second, find out what different pharmacies charge for your drugs.  You may see a difference that can save you some time in reaching the donut hole. 

     

    What you need to know about the Basics of MEDICARE

    Part A is provided by Social Security and covers HOSPITALIZATION.  The deductible is $1,484 and most people do not pay a monthly premium.

    Part B is also provided by Social Security and covers DOCTOR VISITS at 80%.  In 2021 the Part B premium increased to $148.50/month.  Most people have the premium deducted from their Social Security.  The deductible for Part B is $203  As a side note, Part B premium is based on income.  If your income is greater than $85,000 for an individual or $170,000 for those that file a joint return, you will pay a higher premium.  

    *These figures have not been updated for 2022 yet and may be subject to change.*

     

    WHAT DOES THIS MEAN???  If you have only original Medicare, you will pay 100% of your doctor visits and hospital visits until you reach your deductible.  Once you meet the deductible (i.e. $203 for doctor visits) Medicare will start paying 80% of the bill.  You are still responsible for the remaining 20%.

    It is important to note that not all doctors accept Medicare.  You will need to confirm with your doctor that they accept Medicare before making your appointment.

     

    HOW TO FILL THE GAPS???  Many people purchase a Medicare Supplement plan to fill the gaps.  The most common plan today is Plan G.  These plans cover the Part A deductible and the Part B co-insurance (20%).  Medicare Supplements are provided by private insurers (i.e. BCBS, United Healthcare/AARP, Mutual of Omaha, Aetna, etc.) and charge a monthly premium.  The premium will vary by age, carrier, and zip code.

     

    Another option is a Medicare Advantage Plan.  These plans have a lower monthly premium, include prescription drugs, and are subject to the enrollment period noted above.  Medicare Advantage Plans are set up as “pay as you go”.  Meaning the monthly premium is less than a supplement/prescription drug plan, however you pay a co-pay for each of your services (i.e. $5 co-pay to see the primary care physician, $10 co-pay to see a specialist, etc.).  These plans are offered by private insurers (i.e. Blue Cross Blue Shield, Human, United Healthcare/AARP, etc.)

     

    WHAT ABOUT PRESCRIPTION DRUGS???  For those that are Medicare eligible, you are REQUIRED to purchase a prescription drug plan if you do not have credible coverage.  Prescription drug plans are provided by private insurers (i.e. BCBS, Humana, United Healthcare/AARP, etc.), NOT Social Security.  Many people think prescription drugs are included in Part A and Part B…they are NOT.  If you choose not to purchase a plan, you will be penalized for each month that you do not have coverage.  Once a drug plan is selected, the penalty will be added to the premium.  Please note, the penalty is NEVER removed.  

    Prescription Drug plans are subject to an enrollment period.  The enrollment period is NOW.  If you qualify for a special election period (i.e. aging in to Medicare or losing credible coverage) you will be eligible for enrollment based on the date of your eligibility.

    Prescription Drug plans have a monthly premium, co-pays are charged based on which Tier your drug falls in to, and some plans charge a deductible.  It is important to review your drug list before switching carriers. 

     

    WHO IS ELIGIBLE FOR MEDICARE???  People that are 65 or older or those that have been disabled and collecting social security disability for 24 months. 

     

    Your Guide to Medicare 2020-Open Enrollment.

    Posted: October 28, 2019

    It’s time for Medicare Fall Open Enrollment.  Knowing how to navigate coverage options and understanding what changes are in store for Medicare in 2020 will help you make the most informed decisions during Fall Open Enrollment.

    During this time, you can make changes to your prescription drug plan, enroll in a plan, change your Medicare Advantage Plan, or enroll in a Medicare Advantage Plan.

    WHO IS ELIGIBLE FOR MEDICARE?  People that are 65 or older or those that have been disabled and collecting social security disability for 24 months.


    What to Expect in 2020

    • Plan F will no longer be offered to newly eligible enrollees.  If you have a Plan F currently, your plan will remain the same.  If you became eligible for Medicare before January 1, 2020 you will still be able to enroll in Plan F.
       
    • Humana had made a change to their prescription drug plan.  Those on the Humana Walmart Plan have been re-mapped to the Humana Premier RX plan.  Humana is offering a less expensive option, but we MUST make sure your drugs are covered in the new plan.  If you want to discuss your options, please have your list of drugs available.
       
    • The Part D (prescription drug) deductible has increased to $435.  Many carriers offer plan with $0 deductible for drugs in Tier 1 or Tier 2.
       
    • Donut Hole: The initial limit has increased to $4,020. 
    • United Healthcare/AARP and Blue Cross Blue Shield have little to no changes to their plans for 2020.  If you are happy with your plan, the plan will automatically renew. 

    Tips to Reducing Your Medicare Premium

    • Consider a Medicare Advantage Plan.  If you are already in one, you may want to consider another carrier.  Be sure to pick a plan with a maximum out of pocket and confirm that your doctors accept the plan before switching.  This will protect you in the event of a “bad” year.
    • Consider switching the type of Supplemental Plan you are in currently (i.e. Plan G is often less expensive than a Plan F).  I will caution, changing your plan may require you to pay for services that you have not paid for in the past.  For example, a Plan N will charge the $185 deductible and $20 co-pay for doctors’ visits. 
    • Review your drug lists with other carriers.  Medicare.gov is a great source for reviewing rates with other carriers.  Simply plug in your drug information, select your pharmacy, and review the different plans available (based on the drugs you are taking).  
       
    • Consider switching pharmacies.  First, watch to make sure your pharmacy is still in the Preferred Network with your prescription drug plan.  Second, find out what the different pharmacies charge for your drugs.  You may see a difference that can save you some time in reaching the donut hole. 
       

    This is an extremely busy time for me. I suggest scheduling early as my schedule will fill up.  Contact me at 708-444-0050 or kelly@kellyburkeinsurance.com.

    Please include your availability (i.e. mornings, afternoons, or evenings) and the type of appointment you are requesting (face to face or conference call). 

    2019 Open Enrollment. Important Details You Need to Know.

    Posted: November 26, 2018

     

    During this time, individual policy holders can enroll in a health plan or make changes to their existing plan. *If you obtain health insurance from your employer, you are likely to have a different Open Enrollment period.*

     

    What to Expect in 2019

     

    • The penalty has been removed! This means you will no longer receive a penalty for not having coverage or for obtaining a plan that does not provide the 8 coverages required by the  Affordable Care Act.
    • Short term medical plans will now offer coverage for the full year. These plans do not provide coverage for pre-existing conditions, maternity, or wellness visits. However, these plans are a fraction of the cost of plans offered through the Marketplace and they all have a PPO network.
    • BCBS will continue to offer virtual visits for PPO plans only.  Policy holders can call or chat online with a nurse practitioner to obtain a diagnosis and prescription for medication.
    • Group plans are still an option for small employers. Blue Cross Blue Shield does offer relaxed guidelines during this time to allow for a 1-person group. The employer must have at least 2 full time employees that are not husband and wife.

    How to Avoid Rate Increases

     

    • Be prepared to discuss your household, estimated adjusted gross income for 2019.  This will be used to determine if you qualify for assistance.
    • Those without pre-existing conditions should consider a short term medical plan.  The premium is much lower and all plans offer a PPO network.  Wellness visits are not included with these plans.
    • If you are going to opt to self-insure, protect yourself with an accident or critical illness plan.  The plan works separate from health insurance and pays you based on a diagnosis of a critical illness (cancer, heart attack, or stroke) and in the event of an accident (slip, fall, and break an ankle) the plan will pay you a certain dollar amount.  The purpose is to use the funds to pay towards the unexpected hospital or urgent care visit.
    • Review ALL of your insurance policies. I specialize in personal lines insurance, which includes auto, home, and Medicare. As a broker, I have access to multiple carriers which allows me the opportunity to find the best plan based on your needs.  I’ve saved people thousands by reviewing rates with multiple carriers.

    NOTE:  This is an extremely busy time for me.  I suggest scheduling early as my schedule will fill up.  Call 708 444-0050 or email, kelly@kellyburkeinsurance.comfor an appointment.  Please include your availability (i.e. mornings, afternoons, or evenings) and the type of appointment you are requesting (face to face or conference call).

    Open Enrollment Events

    Posted: October 11, 2013

    I will be participating in multiple events during open enrollment.

     

    *Healthcare Reform/”Obamacare” Open House
    Every Saturday starting October 5th-December 14th 10am-2pm
    Prime Realty: 17208 Oak Park Avenue Tinley Park, IL 60477
    -The open house will be closed November 30th-

     

    *Medicare Open House
    Every Tuesday October 15th-December 3rd 10am-2pm
    Additional dates added December 5th and December 7th 10am-2pm
    Prime Realty: 17208 Oak Park Avenue Tinley Park, IL 60477

     

    *Medicare Community Event for United Healthcare/AARP Plans
    October 29th and November 13th 10am-11am
    Prime Realty: 17208 Oak Park Avenue Tinley Park, IL 60477

     

    *Healthcare Reform and Medicare Educational Booth
    CVS 8811 W 87th Street Hickory Hills, IL 60457
    October 16th 2pm-6pm
    November 6th 2pm-6pm
    December 4th 2pm-6pm
    January 15th 2pm-6pm
    March 5th 2pm-6pm
    March 19th 2pm-6pm

    Questions
    Questions

    Feel free to email or call me with any questions or comments about my services or if you have any insurance related inquires.

    Contact
    Contact

    Phone: 708.444.0050
    Email: kelly@kellyburkeinsurance.com

    Availability
    Availability

    Monday - Friday: 10am - 5pm
    Evening and weekends
    available upon request