How do I know if I need a Medicare Advantage Plan or a Supplement?

Medicare can be confusing. We can all agree on that. But it doesn’t have to be. What it really boils down to is that your options are limited, which makes things quite simple. You can go one of two routes. The first is an Advantage Plan and the second is a Supplement, or what some people may refer to as Medigap. Let us break these down to hopefully help you decide which is the best fit for you and your health care needs.
Keep in mind that this is after you’ve already enrolled in “original” Medicare Parts A and B, which provides the basic hospital and physician coverage. See our video here for instructions on enrolling in Parts A and B: How to enroll in Medicare parts A and B. That must be done first, and then you can essentially “buy up” whichever other coverage you’d like.

•    Route 1: Medicare Advantage Plan
Think of this option as a replacement policy for A and B. It essentially takes the place of your original coverage and is used just like an individual under 65 health plan would be. Most times, there are copays or coinsurance for services, a deductible to meet and an out of pocket maximum. This plan will have out of pocket expenses but the monthly premium is typically very low, considering. With this plan, you would use this card at the doctor in place of the original Medicare ID card. Advantage Plans and their provider networks can vary by county so it’s always safe to confirm that your physicians are part of the network.

Example of coverage: The current Florida Blue Medicare Advantage Plan for 2020 has a monthly premium of $47.90. Pretty inexpensive, right? There is coverage such as a $10 copay for an in-network family physician, $45 copay for a specialist, $50 copay for urgent care, $90 copay for ER visit, $295/day for inpatient hospital care, and a $6,500 out of pocket maximum. This plan also has prescription drug coverage built in at different tiers depending on the medication.

Ideal client for this plan: Someone that may not visit the doctor often, has no major health concerns or current struggles, has the financial ability to pay the out of pocket maximum in the event something big happens unexpectedly.

•    Route 2: Medicare Supplement (“Medigap”)
A supplement is in addition to original parts A and B. It fills in the blanks of what A and B don’t cover. Now because of that, it will only cover things that Medicare does because it basically follows suit with Medicare and then supplements the gaps afterwards. This plan does not have copays or coinsurance or out of pocket expenses. It has a higher monthly premium so that it covers almost everything at the time of service. At a Doctor visit, you would use your original Medicare ID card first along with this one.

Example of coverage: There are several different levels of supplements but the most popular one that is available now is the plan G. There is an annual deductible for the part B coverage that the supplement will have, which is $198. Once that is met, essentially everything is covered at 100%. The current plan G monthly premium in Gainesville, FL is $180.60. It’s important to note that the supplement does not cover prescription drugs and those must be purchased in a separate Part D plan. I know this sounds like alphabet soup but stay with us!

Ideal client for this plan: Someone that frequents the doctor, has some health issues or is prone to illness, can afford the higher monthly premium for peace of mind, or someone that just doesn’t want to have to worry about health care costs.

That’s it! Congrats! You made it through the treacherous trenches of Medicare. There are only two routes and you get to pick! We always like to get a better feel for clients’ individual situations and health care needs to better advise the best fit but it’s pretty simple. And as we mentioned, there’s a separate Part D drug plan for prescription coverage with the supplement route… you can get more information on that here: Part D drug coverage. If we can ever be of assistance and help simplify this process or guide you to a decision you’re comfortable with, please contact us at 352-371-7977 or info@mcgriffwilliams.com.

79% of people that quit their job said it was due to “lack of appreciation”?!

If you’re a business owner or HR professional that cares about your staff and employee retention, this is something you don’t want to miss. The need for good company culture and employee retention are at an all-time high for businesses operating smoothly. You may not see anything wrong with your culture or the perks you provide for employees from your perspective, but be sure you stand in their shoes when thinking about what you can offer them to make their lives easier.

Often times, companies provide perks such as office snacks in the kitchen or a gym membership. Let’s say someone is dieting and they only have time for at-home workout programs that they can do in the morning before the kids wake up. Those so-called “perks” mean nothing to them. Yes, it’s the thought that counts but it’s ineffective. There are tons of other examples of perks that can be offered but it’s merely impossible to personalize them to every individual based on their needs. Unless… drumroll, please… You let them create their own perk. Tada!
What if you gave your employees the freedom and ability to choose how they’d like to receive benefits? Maybe Susan has been wanting to take her grandkids to Disney World but can’t afford the tickets. What if Jared hasn’t been able to visit his family in Oregon in three years because flights are so expensive? And about that gym membership idea… it’s brilliant to encourage health and wellness but for Maria that can’t make it to the local gym during the day, she can get an online workout program or a Peloton to exercise at home once she picks the kids up from school. There are so many options that can be tailored to each person to be a true benefit to them and make their life easier. Here are more examples:

• Student loan payment
• Personal or professional development
• Childcare/babysitting
• Dry cleaning
• Vacation
• Cell phone bill
• Financial Advisor/wellness
• Charitable giving
• Pet insurance/care
• Technology

 
There’s a company called Compt that saw the need for this and provided a solution. It’s essentially a lifestyle spending account or an employee “allowance”, if you will. You decide how much you can afford to give each employee per year as well as what categories or spending they can do. Then they spend the money, submit their receipts & get reimbursed. Easy as pie! (Except pie is actually kind of hard to make… this really is easy, promise.)
The idea is genius and the execution is simple. And the end result is that you get to keep your good employees around long-term and prove to them how valued they are. According to the Employee Engagement Report of 2019, employees who don’t feel valued at work are 34% more likely to leave their companies. And 79% of people that did quit their job said it was due to “lack of appreciation”. Don’t be part of that statistic. Now go show some love!

Disability Questions Every Doctor Should be Asking

Attention medical professionals! When was the last time you discussed disability insurance? Have you thought about the financial repercussions that could very easily become a reality for your family in the event that you are hurt or unable to work?

Here are a few questions every physician or professional in the medical field should be asking regarding disability insurance:

•    What if I can’t perform the typical duties of my occupation, but could do something different and still earn a lower income? Great question! There is something called “True Own-Occupation” for this situation, in which you could collect both the disability benefit as well as the new income.

•    What if I’m able to work just part-time or at a reduced income but not my usual full-time schedule? Glad you asked! There is “Partial Disability” which actually makes up the majority of claims industry-wide. This is when there is a partial or residual claim where the insured is working, but less than usual.  This rider makes sure it is not an “all or nothing” claim.

•    What if I want to change my coverage as my income increases over time? We like where you’re going with this! There is a “Future Increase Option” that gives you the ability to increase your monthly benefit typically every 3 years without future medical underwriting.

•    What about inflation between when I get my policy and claim time where I actually need the benefit? Another good one! You’re in luck. The “Indexing/Cost of Living Adjustment” rider is an option that keeps the monthly benefit current with inflation at claim time to avoid any gaps.

•    Are there exclusions for Mental/Nervous/Substance Abuse claims? Asking for a friend? Many carriers will limit these types of claims to 24 months but others will treat them like normal claims and pay out to the regular benefit period such as age 65, 70, etc.

•    Shouldn’t I get a discount for being a member of organizations like the Florida Medical Association? You deserve it! Some carriers offer up to a 10% discount to Florida Medical Association members.  Most carriers also offer a multi-life discount as well… typically when you have 3 or more people in the same practice, they will discount the rates from the unisex rates. This is usually about a 10-30% discount (higher discount for females since their premiums are already higher).

Your options with disability insurance are endless and vary on an individual basis. It may not be the most fun topic of conversation or you may think it won’t happen to you. But especially being in the medical field, it’s crucial to at least ask the questions. And it’s most important that you understand the value in this coverage and how serious protecting your family is.

Prevent your next HR nightmare!

Think you don’t need an Employee Handbook or that yours is sufficient as is? Think again. It is extremely important to keep a current Employee Handbook.

Some misconceptions of business owners or HR directors may be:
• No time or resources
• It’s too much work
• Afraid we’ll miss important compliance/law changes
• Not a company priority
• Don’t think a Handbook is necessary for our business
• We’ve already finished our updates this year

Your Handbook does a lot for you that shouldn’t be overlooked, such as:
• It tells your story and you have the opportunity to be a really great narrator
• It sets the tone for your company culture and clearly communicates the mutual expectations with your employees
• It explains your purpose, your why and your how
• It defines and explains the benefits you offer to your staff, adding value and morale to your operation
• Your openness and transparency will go a lot further than you might expect
• Delivers brand or information change promptly and efficiently

There could be substantial consequences of not having an accurate, up-to-date Handbook:
• Your exposure to legal action being taken against you
• Missing or inaccurate information is misleading
• Employees may not feel comfortable going to management when they should be able to refer to the Handbook to avoid feeling hesitant
• Staff will not feel confident if there’s a lack of guidance and support from their leadership
• Changes in state/federal laws that affect your policies will be overlooked
• Harassment and discrimination issues could be avoided

As always, if there are ways we can help with your Employee Handbook or implementation of it, please contact us any time at (352)371-7977 or info@mcgriffwilliams.com.

No more Medicare Plan F supplement in 2020?

Believe it or not, Open Enrollment season is upon us! There’s been a lot of talk lately about the Medicare Plan F supplement going away in 2020. Here are some helpful facts to clarify what our new reality looks like.

For decades now, the Medigap Plan F has been by far the most popular supplement purchased for Medicare eligible individuals. The fact that it covers all deductibles, coinsurance and copays easily justify that. For many, this has been the first time they’ve ever had no out of pocket expense when receiving medical care such as a doctor visit, lab work, or even a surgery or hospital stay. This is what some may refer to as “first dollar coverage” since whichever company you got the supplement from pays immediately. Sound too good to be true? Well, if you weren’t eligible for it by the end of 2019, it is no longer available.

Along with Plan F, the Plan C supplement is, although less popular, also no longer available starting January 1, 2020. The common denominator between the two is that they both cover the Medicare Part B deductible. Based on the Medicare Access and CHIP Reauthorization Act, Congress has decided that they no longer wish to have plans available that pay the first dollar, without any deductible to meet, because patients may access care more often or unnecessarily.

For those already on Plan F (or even eligible but not yet enrolled), the good news is that you can keep it! You are “grandfathered” in on that supplement, at least for the time being. Rates may increase over the years but that’s always a possibility. For others moving forward, the Plan G will be the next best option for a Medigap supplement. G covers everything that F does except for that Part B deductible… but often times, the difference in premium comes out to be almost the same in the end.

Medicare can seem like a very overwhelming, stressful transition in health insurance, especially when there are heavily regulated guidelines and changes like this. We are happy to discuss how this affects you or your loved ones and help guide you to the best protection for your needs.

Please email info@mcgriffwilliams.com or call (352) 371-7977.