10 Year Anniversary Celebration!

BGA Insurance celebrated 10 years of providing excellence in senior healthcare, Medicare, and retirement planning. We gathered the troops at the Fairmount Water Works to have a grand old time!

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The article 10 Year Anniversary Celebration! originally appeared on BGA Insurance Group


Cigna Purchases Express Scripts

That’s the big headline everyone is seeing over the past week. I’m addressing it because it makes people nervous, but that is the world we’re living in. Come on, you should be used to this by now, bigger companies buying up smaller companies!

We are a capitalist society, so this should not surprise anyone. This is not new news as we already have read that CVS has agreed to buy Aetna last December.

Cigna is one of the country’s largest health insurers, and Express Scripts is one of America’s biggest pharmacy prescription providers, which administer drug plans for more than 266 million Americans with employer health plans and government health insurance plans. Government, meaning Medicare.

If this merger does happen, it would be the latest one to throw a curveball at the Medicare health and Part D program. It’s no secret that the current administration has pointed out that there has been heavy pressure to reduce drug costs which since the birth of the Part D program has spiraled out of control.

As BGA Insurance agents, we see this problem everyday and it’s really been costly for our seniors and continues to be a burden on their retirement planning. Personally speaking, I’ve never been an advocate for our governments role in our healthcare but being that they do operate the Medicare program they must do a better job getting involved and putting pressure on the drug manufacturers and pharmacy benefits managers.

Yes, they are doing a better job over the last few years reducing the donut-hole, but it hasn’t nearly been enough in my opinion. Ask any senior if they ever had to lay out money for a 30-day supply for a brand name drug. Most brands run in the hundreds for a just a 30-day supply and have seen numerous scripts cost thousands.

Seriously, how can some seniors afford to retire? I know I’m getting off the main subject here and going off on a rant, but we see it day in and day out and its heartbreaking to witness.

ordering prescription medicine

If this merger does happen it could give Cigna more control over drug prices which would cause quite a stir for major insurers. Is this a good thing or a bad thing? Hey, United Healthcare already has been administering its own drug plan called “OptumRx”.

We already sense that the federal government is not rallying around these mergers as a federal judge blocked the $54 billion merger of Cigna and Anthem last year.

So, you ask, “how are these mergers going to affect me and my healthcare costs?” Right now, we don’t know. But what I do know is that the BGA agent will always bring you the latest information and updates as they occur. The BGA agent will always keep up on continuing education, we are required to by state law.

Every day while sitting down with potential clients, the majority of our time will always be spent on prescription costs and the Part D drug plans. I have clients who are lawyers who spend hours reading and writing important documents for a living who can’t wrap their heads around this.

When I wrap up a meeting with a senior or seniors I always reiterate to always call or email me every October before the AEP (Annual Enrollment Period).

Why? Because I want to make sure you are getting the best pricing for your prescription costs because they are constantly changing on a yearly basis. It’s just not me, this is the service that every BGA agent provides their clients with. I push this point because don’t do it alone, lean on our educated expertise, it’s what we’re here for. Not only that, it won’t cost you a dime, it’s a free service.

Let BGA Insurance be your advocacy group.


Joe Bachmeier is a co-founder of BGA Insurance Group

The post Cigna Purchases Express Scripts appeared first on BGA Insurance Group.

The article Cigna Purchases Express Scripts originally appeared on BGA Insurance Group

Human Resources – Advice to Retirees

Hello to all the HR personnel out there who carries the burden of trying to relay Medicare advice to your retirees. Guess what? If you have an open mind that burden can be lifted and as a free service no less.

That’s what BGA Insurance Group is all about; providing free services to all HR departments and to their current and past retirees.

Just to provide you with a little bit of history, I’ll give you the “Readers Digest” version of it all.

BGA was formed in 2008 with the sole purpose of assisting retirees and seniors with choosing the best Medicare and Part D options.

If you think about all the literature, brochures, letters etc. that have been mailed to anyone retiring or turning 65 you would think the focus of insurance carriers would be to wipe out all the trees and forests on the planet. It creates nothing but confusion for the Medicare recipient and a lot of wasted paper.

Ask any senior or retiree if they were never guided properly and how much money it set them back.

This coming May BGA Insurance Group will be celebrating it’s 10-year anniversary!  An important milestone that we are all proud of. Over the course of the last 10 years, we have seen a lot of changes to Medicare, private insurances, and the consumer.  In our effort to reach even more retirees who may be frustrated by not receiving all the correct Medicare information, we are adding a new repertoire to our focus.

In addition to reaching out to seniors individually, we are also meeting with human resource departments to relieve them of the burden of cycling through all the confusing Medicare rules and options.  BGA wants to provide human resource departments the same experience we provide to our retirees and seniors that we meet with on an individual basis.

Why do I think this is a great idea? Think about this for a moment.

As an HR employee, have you ever given a retiree a bit of wrong information purely by mistake? It’s nothing to be ashamed of because Medicare can be a very daunting task with all the changing methods and regulations on an annual basis.

For example, Cobra is no longer considered credible coverage by Medicare, did you know that? Very few people do.

Long story short have you ever given the advice to a retiree about jumping on to Cobra? The way it reads now is that any retiree optioning for Cobra once their credible coverage has ended may now endure a penalty by Medicare. Who will that retiree be upset with, Medicare or their HR person who recommended Cobra?

Let BGA Insurance Group help you now and relieve you of that burden. After all, it cost the HR department nothing as well as your retiree. It is a free service provided to everyone involved. As agents we are required to keep up with our “continuing education” to maintain a license, you shouldn’t have to worry about this in the HR department.

Over the last week or so BGA has been successful in partnering-up with a few large sized companies and their HR personnel departments. In fact, these companies were relieved that we reached out to them and explained exactly what we have to offer. Don’t be left behind, we can be a very valuable asset to your department and your retirees.

How can we help your organization?

  • We can meet with you and your staff to review and answer questions about how Medicare works for current employees, their spouses, and retirees.
  • Assist retirees with their healthcare options in-person, on the phone, or give them the proper tools to do a self-guided search for the right plans to fit their needs.
  • Create brochures and a website (platform is already created) for your retirees branded with your company logo (if desired) to help so they know they are in the right place to find information and assistance when researching and enrolling in plans.
  • The best part of all this is that we are in contact with our clients on an annual basis reviewing their coverage. BGA will provide the same customer service to your retirees making sure they are always updated on any Medicare changes and any changes they might want to make regarding their healthcare.

Read some of our many testimonials to learn how we have helped many seniors choose the right plan for them.


Joe Bachmeier is a co-founder of BGA Insurance Group

The article Human Resources – Advice to Retirees originally appeared on BGA Insurance Group

Mutual of Omaha Advantage Plans in 2019

It has finally been announced, Mutual of Omaha will offer Medicare Advantage plans in 2019.

Since the inception of Medicare back in 1966 Mutual of Omaha has been the #2 largest Medicare supplement (Medigap) provider to Medicare recipients. Since that time Mutual of Omaha has never entered the Medicare Advantage market.

To help launch the Medicare Advantage program, Mutual of Omaha will be teaming up with Lumeris Inc. who is based in St Louis. Lumeris develops and provides technology solutions and strategic advising services to healthcare organizations.

The company also offers consulting services in value-based care model, including incentive contract design, education on practice redesign, support to health systems, and payers. It provides guidance in launching Medicare advantage health plans, commercial, and government health plan optimization; and multi-payer and multi-population health services organizations.

Lumeris will take care of setting up the provider networks for Mutual of Omaha.

James Blackledge, Mutual Chairman and CEO added “We’re confident that our collaboration with Lumeris will lead to better health outcomes for our Medicare Advantage customers.”

Mutual is a major player providing Medicare recipients with Medigap plans will most likely account for more than 8 billion in revenue this year. Mutual will own the plans under the Mutual Medicare Advantage name and will provide brand, marketing, and distribution expertise. Mutual of Omaha will expect the first plans to be ready for the Medicare open enrollment period that starts Oct. 15, with advertising leading up to that and plans taking effect Jan. 1, 2019.

Ok, so what does this major news mean to BGA Insurance Group? This is very exciting news because in the Philadelphia five county area the major players in the Advantage plan market has been either Aetna or Independence Blue Cross with a little sprinkle in of Coventry, Humana and United Health Care.

But the fact is the plans who have the largest networks are Aetna and IBC. How about New Jersey? The last couple of years it was Amerihealth and now pretty much just Aetna. This will benefit both markets because it will give our BGA clients more choices, and when you have more choices you have lower premiums.

As I have stated many times BGA covers a tremendous area between PA, NJ, DE, SC, NC and FL, with many more states to be announced. I know it’s just February, but this news will be a reminder over the next 8 months how busy the 2018 Annual Enrollment Period will be and BGA Insurance Group will be ready to provide you with all the important information on these new Mutual of Omaha plans; and of course, any changes with your current Advantage plans.

Let me say this to all our Medicare Advantage plan clients, put your BGA agent on the calendar for October 1st, because it will be in your best interest to receive this information. Also, don’t forget to tell your friends!


Joe Bachmeier is a co-founder of BGA Insurance Group

The article Mutual of Omaha Advantage Plans in 2019 originally appeared on BGA Insurance Group

Medicaid Income Limits & Eligibility for 2018

What is Medicaid? I bring this subject up because a lot of folks out there are confused, mostly Medicare recipients who often think Medicare is Medicaid.

Medicare and Medicaid are two different government-run programs that were both created in 1965 so people who reach “senior” status and low-income citizens are able to purchase private health insurance. Medicare and Medicaid are social insurance programs that allow the financial burdens of illness to be shared among healthy and sick individuals, and affluent and low-income families.

However, Medicaid is not Medicare.

Medicaid is a jointly funded Federal and State health insurance program for low-income and needy people. It covers children, the aged, blind, and or disabled and other people who are eligible to receive federally assisted income maintenance payments. In other words, Medicaid is a state and federal program that provides health coverage if you have a very low income.

Medicare is a federal program that provides health coverage if you are 65 or older or have a severe disability, no matter your income. This basically means you should receive no assistance paying for your secondary insurance. All cases are not the same because there are Medicare funded programs for some Medicare recipients, for example Pace and Pace-net.

Here is some recent news on Medicaid and the requirement to work:

Here at BGA Insurance Group we run into a lot of folks who are eligible for both Medicare and Medicaid. The term we use for this is (dual eligible). This means you can have both Medicare and Medicaid and it will work together to provide you with very substantial health coverage. Unlike Medicare Advantage, Original Medicare and medigap plans will not fall under the dual eligible umbrella.

The current national statistics say that 1 in 5 Americans who are low income with many costly needs for healthcare fall under the Medicaid system. The Affordable Care Act expanded Medicaid to reach low-income adults previously excluded from the program. Over the last 10 years there has been considerable federal funding for this program in addition to state funding.

There are a lot if debates right now in DC about how much federal funding should be thrown at Medicaid. Over the last 9 years we had an administration who used Medicaid funding to certain states as a deal breaker to get the Affordable health care act pushed through.

Now we have an administration who have called for major changes to Medicaid to hold back on federal funding and believe it should be governed by the states as originally planned. There is a lot of data, research and information that has critics at odds about the Medicaid program.

States have received strong financial incentives to manage Medicaid closely and ensure the program’s integrity because they must pay a large share of Medicaid costs and must also balance their budgets.

I bring this up because with all the changes Washington makes regarding Medicare and Medicaid it is important to keep in touch with your BGA agent for the most updated information and facts.

What does Medicaid cover? Although prescription coverage is an optional benefit under federal Medicaid law, all States currently provide coverage for outpatient prescription drugs to all categorically eligible individuals and most other enrollees within their state Medicaid programs.

Some mandatory benefits include inpatient hospital services, outpatient services, physician services and home health services and other benefits included. Optional benefits include prescription drugs, physical therapy and occupational therapy. It is important if you fall under the Medicaid program that you ask your BGA agent what is covered and what is not as every state is different.

Some people ask how often can I change my Medicaid coverage? If you have Medicare and full Medicaid coverage, you can change plans at any time throughout the plan year for example month to month. The plan change will be effective at the beginning of the next month. With traditional Medicare and a medigap plan you can also change any time but you be subject to qualified underwriting.

Where do you apply for Medicaid? In Pennsylvania you can apply in person, through the mail and online. If you want to apply in person you can do so at your local County Assistance Office. There are several locations throughout the state of Pennsylvania to ensure all residents in need of assistance receive it.

If you prefer to apply on-line you can apply through the Department of Human Services’ website. “COMPASS”, Pennsylvania’s health portal, can be accessed at any time of day or night, and can be used to apply for Medicaid, as well as other state-sponsored services. You can also apply by telephone by calling the toll-free number 866-550-4350 and speak to a local representative.

Remember that although you may be applying in the state of Pennsylvania there are different strokes for different folks regarding coverage. BGA Insurance Group is appointed with many A rated insurance carriers like Independence Blue Cross, Aetna, Coventry and United Health Care just to name a few.

BGA is now licensed in Pennsylvania (PA), New Jersey (NJ), Delaware (DE), North Carolina (NC), South Carolina (SC), Maryland (MD) and Florida (FL).

Please contact us if you are looking for income limits or other information as well as dual-eligibility.


Joe Bachmeier is a co-founder of BGA Insurance Group

The article Medicaid Income Limits & Eligibility for 2018 originally appeared on BGA Insurance Group

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.

States we cover:


New Jersey




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