Stay informed with the latest news.

What’s Next??

*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

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. 

 

September is Life Insurance Awareness Month

Posted: September 26, 2021

6 Life Insurance Myths Debunked by Kelly

 

Myth #1: Life Insurance Costs Too Much

It is less than you think!  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.

 

Myth #2: I’m single and young, so I don’t need life insurance

Single people often forget that they need at least enough life insurance to cover the costs of debts, medical and funeral bills. If uninsured, you may leave behind unpaid expenses for your family. Don’t forget, the earlier you buy life insurance, the better because the premiums are based on age and your health is on your side!  

 

Myth #3: My Term Life Insurance Coverage at Work Is Sufficient

This one comes up A LOT.  You should know in most cases; coverage goes away if or when you leave the employer.  This means if you quit, get fired, or RETIRE you will lose the coverage.  Put that in perspective with the premium quoted in Myth #1 and you’ve just cost yourself significantly more in premium.  Most people retire in their 60’s.  That same estimate quoted in Myth #1 will now cost $105 per month for a 20-year term vs the 30-year term. 

Also note, the amount of coverage is generally restricted to 1–2 times the salary, which in most cases wouldn’t be sufficient to meet the expenses of dependents in case of the unfortunate incident of death.   

 

Myth #4: Only Breadwinners Need Life Insurance Coverage

The cost of replacing the services formerly provided by a deceased homemaker can be higher than you think.  Insuring against the loss of a homemaker may make sense, especially when it comes to cleaning and daycare costs.  Put into perspective some of the responsibilities of the homemaker…getting kids dressed, fed, off to school, back from school, off to extra-curricular activities, cleaning, homework, and dinner.  Go to www.care.com for an estimate of these services.  The average costs range from $15-$20 per hour, costing you $2,400 per month for a typical 8-hour day.  Wouldn’t it be easier to buy a life insurance policy for $20 per month??

 

Myth #5: I Have Existing Health Issues. I Cannot Get Life Insurance.

There’s more to it!  There are a number of other variables that insurers look at before offering coverage at certain rates for specific health problems. Although premiums may be slightly higher, most life insurance companies are willing to offer you coverage if you are suffering from conditions like diabetes, high cholesterol and arthritis. Past history of cancer; no problem. Depending on the stage and how many years in remission you can qualify for a standard rate!  The point is, it doesn’t hurt to ask.  Most carriers provide pre-screening which allows an agent to get an idea if the carrier will offer coverage and at what cost before submitting an actual policy. 

 

Myth #6: It’s Only Good for Funerals & Inheritances

That’s just not true! An unfortunate stigma attached to life insurance is that of death. Traditionally, people bought life insurance for its death benefits, and these benefits are why many still do. But, life insurance offers several living benefits

  • Cash value could be used to supplement retirement income
  • Help pay for college tuition
  • Benefits paid from life policies aren’t subject to tax.
  • Immediate expenses such as medical bills, taxes, loans
  • Payoff mortgage debt
  • Payoff student loan debt

With more parents being listed as a co-signor for student loan debt, many people purchase a term life insurance to cover the debt for the length of the loan.  This way, should the unexpected happen, the parent is not stuck holding the debt.

 

Trump’s Executive Order Defined

 

On October 12th, President Trump signed an Executive Order, forcing changes to be made toward some of the rules of small business health insurance plans, short-term health insurance policies, and cost-sharing reduction payments (aka subsidies). 

 

 What does the Executive Order mean

  • Broader rules for AHP’s (Association Health Plans), allowing small businesses to purchase plans across state lines.  By joining an AHP, small employers within the same line of business could purchase plans collectively. 
  • Increase the policy period on short-term plans from 3 months to 12 months with the option to renew.  These plans are not required to follow the rules of the ACA mandate (i.e. they do NOT provide coverage for pre-existing conditions)
  • Cost-sharing reduction payments (aka subsidies) will no longer be funded by the government.  Insurers are required by law to offer assistance to low-income individuals.  Customers who are currently receiving assistance through the Marketplace will likely see little change.
  • Rates have not been released and likely will not be released until November 1st.  This means renewals will not be available until November 1st. 

How to Avoid Rate Increases:

  • Be prepared to discuss your household, estimated adjusted gross income for 2018.  This will be used to determine if you qualify for assistance.
  • Those without pre-existing conditions should consider temporary insurance.  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.  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.  Personal lines insurance (auto, home, life, and health) is my area of expertise!

Blue Cross Blue Shield Announces MAJOR Network Changes

Posted: September 29, 2015

Open Enrollment this year will be November 1st-January 31st.  During this time, Blue Cross Blue Shield has already announced major network changes.  The biggest being the elimination of their broad PPO network.  Those with a plan in this network will receive a letter and or phone call from BCBS stating that their policy will expire 12/31.  You will need to pick a new plan by 12/15 to ensure there is no gap in coverage. 

 

Those with the Blue Choice, the HMO network, or on an employer plan will NOT be affected by this change. 

 

BCBS has also announced that there will not be a cap on out of network charges, making it extremely important to stay in your plans network.  What this means is that a service that costs $10,000 at an out of network facility will cost you $10,000.  Nothing will be applied towards your deductible.

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

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Availability

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