Medicare Disenrollment 2018 – There’s Still Time

medicare disenrollment formIt’s January 13th, are the Christmas lights still dangling outside your house blowing in the frosty wind? Have you taken down your tree or just left it up because it just looks pretty, or you refuse to let your favorite holiday pass. Or maybe it’s still up because you treat it like you treated this past Annual Enrollment Period saying to yourself “I’ll get to it, I’ll get to it,” and then ask yourself “am I too late?”

I know there are still a lot of people who are disappointed they missed the December 7th deadline to investigate other insurance coverage. I get those late phone calls every year and explain you can still do something about it.

Yes, there is still time if you want out of your Medicare Advantage plan. Most people don’t realize that there is another enrollment period called “The Medicare Disenrollment Period (MADP) which lasts from January 1st through February 14th of each year.

During the MADP, a beneficiary can switch from a Medicare Advantage plan to traditional Medicare. The new MADP also provides an opportunity to enroll in a Part D drug plan for those who have not already done so.

So, we just finished the Annual Enrollment Period which went from October 15th thru December 7th, and we were busy and quite exhausted by the end of it; but after a few weeks off during the holidays, our BGA agents are now well rested and ready to assist you!

Most folks ask, “what can I do?” If you’re in a Medicare Advantage Plan with a Part D plan attached, you can leave your plan and switch to Original Medicare which covers Parts A & B and sign up for an independent drug plan. If you just have an Medicare Advantage plan without drug coverage, you can still switch to original Medicare but without adding drug coverage.

The questions you need to ask yourself are:

Do I like having all these co-pays in my plan?

Would it be beneficial to me to choose the drug plan of my choice?

Am I comfortable with this $6700 out of pocket maximum?

Is it annoying to always need referrals when I need to see a specialist?

Does it scare me that all Advantage plans cover only 80% specialty drugs, which could put me in the poor house if I’m ever diagnosed with cancer?

There are a lot more concerns, and they can be answered by sitting down with a BGA Insurance Group agent.

Remember one thing, however, just because you switch back to original Medicare does not mean you are automatically accepted by a Medigap plan (Medicare supplement). You still need to qualify your health by answering some questions relating to your health history. Again, call your BGA agent because they are appointed with all the Medigap plans in your area to help you find acceptance at the best rate. Also, don’t be shy about asking about getting a household discount, something that an Advantage plan will not provide you.

We can provide you a quote with a very affordable rate from Plans A thru F, but I feel Plan F, G, or N will provide you with the most comprehensive coverage. If you’re coming off an Advantage plan, you will probably find that Plan N will be the least expensive and may help with your decision making.

Regarding a drug plan, there are over 40 to choose from, and that is where you will want to utilize a BGA agent’s skill and education. You can easily make a mistake and cost yourself a lot of money choosing the wrong plan. Part of BGA’s free service is going over your scripts and matching them up with the most affordable plan to help you save your bank account.

I mentioned earlier about cancer drugs and how they are only covered under your Advantage plan at only 80%. As I sit here writing this blog I just received a phone call from a client who I sold an Independence Blue Cross HMO plan two years ago, and she wants me to come over next week to go over a Cancer Indemnity plan that BGA Insurance Group also offers. The reason I bring this up is that you may have other needs and you can still purchase additional insurance to cover gaps you may have in your coverage.

We are nearing the middle of January if this is something you have thought about, reach out now! It’s not too late to assist you in the plan of your choice. Even if you are fine where you are, please pass this information along to your friends. I’m pretty sure you know someone who has complained about their Medicare insurance. Also, remember that we provide an old-fashioned service, we will come to you.

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Joe Bachmeier is a co-founder of BGA Insurance Group

The article Medicare Disenrollment 2018 – There’s Still Time originally appeared on BGA Insurance Group


Medicare Changes for 2018

final week of medicare enrollmentEven though we are knee deep in the 2017 AEP I thought I would take a quick moment to update all our Medicare recipients. Finally, the Centers for Medicare and Medicaid Services (CMS) has announced that the Part B 2018 Premium for Medicare will remain at $134 a month.

Usually we hear rumors about changes before October every year so this does not come at a surprise. As usual, some of you will pay higher Part B premiums due to your income level. If you are new to Medicare, make sure you contact the social security office for clarification on what you will be required to pay.

Now let’s look at the Medicare outline that CMS finally has released regarding other costs such as co-pays and deductibles. The good news is that the Part B annual deductible will be unchanged at $183 a year. This is great news for Medicare recipients and for myself. Appointment after appointment I have been telling everyone that the Part B deductible will probably be the same for 2018 without any concrete evidence from CMS.

As a broker relaying this information can be quite challenging because most seniors hang on to every word you say. My mantra during this AEP has been “now don’t quote me but….” Unfortunately for us brokers, we need to explain these benefits during the craziest time of the year without confirmation from CMS. So today I am glad to say the deductible will not change for 2018.

Moving on to the hospital portion of Medicare, the Part A annual deductible will increase by $24 to $1,340 from $1,316. There is a separate deductible for every hospital stay, usually being separated by at least 60 days during a calendar year. Basically, if you have multiple hospital stays 60 days apart the deductible starts all over again. For those of you with medigap plans, you never even see this cost because your supplement covers the deductible. For those of you with Medicare Advantage plans you end up paying the co-pay associated with each hospital stay.

The Part A coinsurance charge for hospitalizations lasting from 61 to 90 days will increase by $6 to $335 a day in a benefit period; for lifetime reserve days linked to longer stays, it will rise $12 to $670 a day. Again, for those of you with medigap plans you are usually protected from these costs. For those of you who have Medicare HMO’s this is the time of year to reach out to a BGA agent to compare what you have and inquiring about protecting yourself from out of pocket hospital expenses.

As you know Medicare recipients are covered for skilled nursing facility care for the first 20 days with no out of pocket expenses, but with stays lasting from 21 to 100 days in a benefit period will increase by $3 to $167.50. Once again for those who purchased Medigap insurance are covered up to those 100 days. Not to go off on a rant here but there is a great policy called short-term care that will cover you for an extended period of time past those 100 days. The good news is these policies are very affordable. Every Medicare recipient owes it to themselves to inquire about this type of planning. Whether you receive the care at a facility or in the comfort of your own home you are covered under the benefits.

We are now in the final stretch drive of the 2017 AEP and we always get the last minute phone calls from seniors inquiring about change. Let me say if you haven’t inquired yet we don’t mind at all if you are one of the last minute calls. It is always in your best interest for the new year because it could save you hundreds if not thousands. When I say thousands, just ask anyone who has a Medicare Advantage plan and has had to receive chemo or radiation treatment. It could mean the difference in your retirement planning.


Joe Bachmeier is a co-founder of BGA Insurance Group

(855) 494-0097

BGA Insurance Group is licensed to help seniors in New Jersey, Pennsylvania, Delaware, and Florida.

The article Medicare Changes for 2018 originally appeared on BGA Insurance Group

Medicare Part B 2018 Update

It is the middle of November 2017 and we are already halfway through the Annual Enrollment Period and there still seems to be a lot confusion relating to Medicare Part B. Some folks have no idea what they’ll be paying, some don’t know when they should start it, some don’t know how to sign up for it, and then some don’t even know what Part B is or what it does.

medicare part b premium 2018

First, Part B is the medical portion of your Medicare, meaning it covers about 80% of your doctor/specialist visits, surgeries, outpatient procedure, x-rays, MRI’s, cat-scans, ER visits etc. To clarify, when you have both Parts A & B you are about 80% covered as far as costs, you then need to make a decision regarding Part C or Medigap supplement insurance to fill in the gap.

One thing I notice a lot is that I meet numerous people who are insured under employer plans because they continue to work past age 65 but have both Parts A & B of Medicare already in place. When you turn age 65 you are automatically enrolled into Part A so you have no choice. However, if you are going to continue to stay covered under your employer’s plan past age 65 you should know you do not need to enroll into Medicare Part B.

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If you do, you will end up paying the Part B premium and you will not even be reaping the benefits of it because your employer plan is still covering your medical benefits. You would be simply throwing money out the window. As long as you are being covered medically under credible coverage you will not incur a penalty of not signing up for Part B.

Now there is a lot of confusion being created when it comes to employers offering Cobra as being credible coverage.

**Buyer Beware**

Cobra is not considered credible coverage and there could potentially be penalties involved so PLEASE reach out to BGA Insurance Group so we can accurately explain your options. If you don’t, you could end up costing yourself a lot of extra money.

Most folks have a good sense of when they are thinking of retiring and start to plan out their options three months ahead of their retirement date, I say, great idea!

If you know your last day of employment will be Feb. 28th, for example, chances are that will be the last day of your medical coverage. Always check with your HR department for confirmation on that because it is vitally important. Let’s use the Feb.28th day as an example, then we know you would want your Medicare Part B start date slated for March 1st, reason being you do not want a lapse in coverage.

That means it is imperative that you call or visit your local social security office so you can fill out the proper paperwork so you can have your Part B date activated. After you’ve done that a BGA insurance agent can sit down with you and discuss all your Medicare supplement options along with the Part D prescription plans.

The exact amount you will be paying for Part B will be declared by Social Security in 2018. You will have to speak with that office for an exact clarification for that amount. Some folks will pay more for Part B than others which is determined on your income. Without getting too political some would argue that is flat-out wrong because we all paid into it with our taxes our whole working-class lives. But it is what it is.

You will pay the normal premium amount if any of the following apply, this is based on 2017 because of course no information is available as of now for 2018 but I am pretty sure the same rules will apply:

  • 2017 is the first time you enroll in Part B
  • You do not receive Social Security benefits
  • You are directly billed for your Part B premiums
  • Medicaid pays any premiums because you have Medicaid and Medicare (therefore your state will pay the standard premium amount of $134)

Your modified adjusted gross income as reported on your IRS tax return from two years ago is above a certain amount. If so, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

Again, the most important thing you need to decide first, is when you will be retiring and how long you will be covered under credible coverage. Next, get in touch with social security and sign up for Part B on your desired date and find ask what your monthly premium will be. After that, get in touch with a BGA insurance agent and the rest is really easy and stress free.

There are about four weeks left of AEP, anyone in PA, NJ, DE, or FL who is confused, wants to change their Advantage (HMO) plan, wants to pay significantly less for their medigap plan or drug plan, reach out, we’re here waiting to assist you.


Joe Bachmeier is a co-founder of BGA Insurance Group

(855) 494-0097

BGA Insurance Group is licensed to help seniors in New Jersey, Pennsylvania, Delaware, and Florida.

The article Medicare Part B 2018 Update originally appeared on BGA Insurance Group

Medicare Part D 2018 Costs

reviewing your annual medicare planHello Medicare recipients. Let me start by quoting one of my agents “It’s that time of year again!” and I just want to take a few minutes here and update all of you on some new costs for 2018 regarding Medicare Part D.

This coming year the deductible phase will be increased by $5 to $405 in 2018. That does not mean every plan has a deductible, all it means is that per Medicare guidelines is that no plan can have a deductible exceeding $405 for the year. Contact BGA about obtaining a deductible free plan.

Next is the initial coverage phase which is also known as the copay or coinsurance phase.

The limit will increase from $3,700 in 2017 to $3,750 in 2018. This is basically where the Medicare member pays a flat copay for his or her prescriptions until the total annual cost of $3,750 is reached.

Next phase once you reach the limit on your copay’s will be the coverage gap also known as the “donut hole.” The TrOOP (true out of pocket) expenses will increase from $4,950 in 2017 to $5,000 in 2018.

In 2018, Part D enrollees will get a 65% donut hole discount on the total cost of their brand-name drugs bought while in the donut hole. The discount is a 50% discount paid by the brand-name drug manufacturer and will apply to getting you out of the donut hole (or TrOOP). One thing to note is that the additional 15% paid by your Medicare Part D plan will not count toward your TrOOP.

For example: If you get to the the donut hole and purchase a brand-name medication with a standard retail price $200, you will pay $70 for the medication, and receive $130 credit toward meeting your 2018 total out-of-pocket spending limit.

Part D members can expect to pay 44% for generic costs and receive a 56% discount. For those of you who only take a few generic scripts really don’t have to worry about falling into the donut hole because the retail costs for generics are usually minimal compared to brand name retail costs.

Catastrophic Coverage is the last phase a member could reach once out of the coverage gap. This is where Medicare picks up 80% of the cost, your Part D plan covers 15% and your responsibility is only 5%.

I know this basic outline is still very confusing for most of you but that’s why BGA Insurance Group is here and you should reach out to an agent for guidance and understanding. By contacting us you could end up saving yourself hundreds of dollars for your 2018 Medicare coverage.

We are licensed in the states of New Jersey, Pennsylvania, Delaware and Florida. Seniors in any of these states should take advantage of our free Medicare enrollment consultations in order to confirm that their current plan is indeed their best option.


Joe Bachmeier is a co-founder of BGA Insurance Group

(855) 494-0097

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The article Medicare Part D 2018 Costs originally appeared on BGA Insurance Group

Medicare Annual Enrollment 2018

medicare annual enrollment

October is upon us! And the season is here for those of you who need to make changes, and BGA Insurance Group is here waiting for you. Remember that Annual Enrollment runs from October 15th through December 7th, 2017.

As our current BGA clients know it’s that time of year to review your PDP costs for 2018. BGA has thousands of clients who are enrolled in independent prescription plans that need to be reviewed, and we leave no customer behind. Make sure you contact your agent because what was good for you in 2017 may not be best for you in 2018. It’s all about being cost-effective, and you may, in fact, save yourself a lot of money.

As most of you know if you have a Medigap plan you can change to another Medigap plan at any time throughout the year. But since we are already reviewing your PDP plan it’s a good idea to ask if you are still competitive regarding your supplement costs. Keep in mind, although you’re allowed to change your Medigap plan you will still be underwritten when applying for a new plan, and of course, underwriting does not apply to Medicare Advantage clients.

Some great news I want to share with everyone regarding BGA Insurance Group. We are now doing live webinars! That means you can view our Medicare presentation online in the privacy of your own home. This is a great tool if you also have a group of friends who want to get together and learn what your entitlements are.

The system BGA uses is very senior friendly, and we are there online with you to answer all your questions and address your concerns. We have had a lot of positive feedback from people who have already taken advantage of this new feature.

Some folks always ask me about the state of Delaware and how it is different from Pennsylvania. As far as Medigap is concerned, we use mostly the same companies. I know Aetna, Cigna, Trans are major players in Delaware among a few others. When it comes to Medicare Advantage, the plans and companies differ greatly but usually cover the same benefits but differ in costs.

If you live in the state of Delaware make sure to contact BGA for pricing and enrollment information.

I know a lot of BGA clients go out of their way to refer their family members and friends to work with us. We thank you! As you know the BGA agent is very patient and prides themselves as a knowledgeable resource when it comes to Medicare and retirement planning.  We guarantee that we will always work within your parameters of your budget and your health care concerns.

We know there are a lot of confused people who find it difficult understanding Medicare, so I ask you to keep referring your family and friends to us. They will always thank you for it.

If you are reading this blog, you already know where to find us, and you can read past blogs that are posted under our “advice” section. I also want to add that you may want to check us out on where we have some informative videos posted and will continue to post new information on a regular basis throughout the year. Please feel free to give us a thumbs up and add a comment or two and let us know what other information you would like us to cover.

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I also want to add that we are also updating our BGA website site under our “team” section. We are updating that section so everyone on our team will have their landing page when you click on their picture. Each agent will also have their Medicareful link that you can enroll yourself on any of our Medicare Advantage plans we offer just by clicking the link on the plan of your choice.

You will also have a few Part D prescription plans to choose from. Just make sure you speak to your BGA agent first so this way you choose the right plan for you.

And lastly some great news on the horizon, BGA Insurance Group will be celebrating our 10-year anniversary this coming May 2018! Yes, ten years! As an agency, we have been so busy we don’t know where the time has gone. It almost feels we’ve only been here for five years. From time to time I still enjoy reading our company bio to remind myself where we came from and where we started.

I want to thank my business partner, management team and all our agents for a great ten years because without all of them there would be no BGA Insurance Group. I can’t wait what is in store for BGA Insurance Group for the next ten years, and we continue to strive for excellence and assist every senior out there.


Joe Bachmeier is a co-founder of BGA Insurance Group

(855) 494-0097

Please contact us if you live in southeastern Pennsylvania, New Jersey, Delaware or Florida.

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The article Medicare Annual Enrollment 2018 originally appeared on BGA Insurance Group