Medicare Part C (Advantage Plan) combines in most cases all of your Medicare services Part A, Part B and Part D into one coverage plan which eliminates some of the out of pocket costs for the enrollees. All Medicare Advantage plans have a maximum out of pocket expense per year for their enrollees, regardless of their health conditions or illnesses. These plans are evaluated by CMS on an annual basis through a Star rating system, one through five, with five star being the highest rating. A five star rated plan can be enrolled into anytime throughout the year, otherwise you must have a qualifying event to enroll. Medicare Advantage plans also provide some services that Medicare does not cover; such as vision, dental or hearing. These additional benefits vary depending on which carrier is providing the coverage.

Provides for prescription drug coverage and was added to the Medicare program in 2006. Prescription drug coverage is divided into four phases. They consist of the deductible phase, cost sharing phase (split 75%/25%), the coverage gap phase (commonly referred to as the donut hole) and finally the catastrophic phase. Prescription drug coverage (Part D) is provided by independent insurance carriers for a monthly premium and is also considered optional coverage. However, if the recipient did not have drug coverage before enrolling into a Part D prescription drug plan there could be a penalty assessed.

Physician based care or commonly referred to as medical care. This level of Medicare coverage is optional (kind of) since it requires a monthly premium. The premium is deducted for most from their social security check and is based on the recipient’s income. Besides the monthly premium there is a $183 annual deductible, once met coverage is split on an 80%/20% basis with Medicare. The recipient is responsible for 20% of the approved Medicare costs with no stop loss. Part B also has a three pint blood deductible for out patient services. If you already have health coverage through an employer or group plan, Part B may not be needed (optional), however, once you lose this coverage you have a time frame requirement to add Medicare Part B or face a penalty later on when you do enroll into Medicare Part B.

Medicare Supplement Insurance policies are sold by individual insurance companies to supplement Medicare coverage or fill-in the gaps (lapses) of coverages provided by Medicare. To be eligible for a supplement plan you must be enrolled into Medicare Parts A & B. These plans have guaranteed issues periods, where regardless of your health condition they must be issued to you. These periods are typically the first six month after enrolling into Medicare Part B, or if you were enrolled in Medicare Part B before age 65 due to a disability or illness upon turning 65 you will have another guaranteed issue period. You can purchase a supplement plan any time after turning age 65, however, unless during a guaranteed issue period you will have to go through medical underwriting. Premiums for these plans are based primarily on age and rate band (zip codes). There are 14 different Medicare Supplement Plans available. Plan F and Plan G are the most purchased plans today.

For most seniors over 65 Medicare and provides their health insurance coverage. There are four individual parts of Medicare, they work independently of each other or in tandem depending on the type of treatment and options selected. Basic Medicare consists of the primary coverages provided in Part A and Part B.

Provides for facility based care, most commonly referred to as hospital care, however, there are other facilities also covered in Medicare Part A. The first level of care is Hospital care, Medicare provides up to 90 days of hospital coverage no matter how many times you need it. When you first enroll into Part A there are an additional 60 days of care beyond the original 90 days, however, these days once used are gone forever. These days can be used all at once if you have a hospital stay lasting 150 days, or can be divided out in multiple stays, 120 days in one stay and 120 days of care in another. Hospital stays have deductibles and co-pays associated with them as well as a three pint blood deductible. Part A for most recipients is available for no additional monthly premium; it is primarily funded by a Medicare payroll tax. There is also coverage for Skilled Nursing facility, up to a 100 day coverage per admittance; Home Health care; Hospice care and Psychiatric hospital coverage.

If we are over 65, Medicare becomes our primary health coverage unless covered by another group insurance plan. While covered by group health insurance plans, Medicare Part B is not required since it is considered secondary coverage. Once you lose your Group Health Insurance coverage you have 8 months to sign-up for Medicare Part B and 63 days to sign-up for Medicare Part D, drug plans.

The primary financial tool is a will. Having a will allows you to decide the distributions of your estate after you have passed. Without a will, a court will appoint an administrator to liquidate and distribute assets. There can be no charitable gifting, no assets pass to non-family members and a potential free-for-all between family members of who gets what, without any concern for your wishes. In most states your spouse will automatically receive at least 50% of the assets, a court decides the rest. With a will, your assets are distributed in the manner you intended.

Many employers offer group life insurance for their employees and their spouses. Most often this is term life insurance, but sometimes it may be a form of permanent cash value insurance. If your employer has greater than 20 employees you will be allowed to take your group insurance with you, it’s called a conversion. You have 31 days from your last day of employment to convert your group policies to individual policies, guaranteed issued. For most, this will be converting from term life insurance to a whole life policy. The premiums for your new policy will be based on what’s deemed your attained age (the age you are when you initiate the conversion). If converting from term coverage to a whole life policy these premiums might be more than desired, however, you may not be required to convert the entire policy amount and with guaranteed issue this could be the cheapest life insurance available to you. You won’t know until you ask.

When receiving a pension may times you are faced with the decision of how to best select benefits: - Life Only - Joint - Survivor (full or reduced). If you are taking pension benefits with less than a full survivorship benefit to a spouse, usually the spouse has to be in agreement or waive their rights. There are a few states where this is not the case though. One thing to look at is the health of all parties receiving benefits. Most pensions are set-up for lifetime payments. If you are married to a younger spouse and you are still insurable it may be to your advantage to select a life only payment structure and buy life insurance on yourself with a portion of the higher monthly income payment. While it is true when you die the pension payments stop, your spouse can use the life insurance proceeds to purchase their own life only annuity, in most cases this can result in a higher payment for you while you are alive and a higher payment for your spouse when they collect on their benefits from the life insurance proceeds.

Should we move to a different state or region? Are we looking at moving for tax advantages, are you moving to get to a warmer climate, moving to be close to family members or just wanting to downsize? The taxation on real estate gains has changed quite a bit over time. If you sell your house you are no longer required to reinvest those monies into new property to avoid taxation.

Should I leave my money with my current employer or move it to another custodian? In general, the recommendation is to transfer this money into a rollover IRA. Inside an IRA you will have more investment choices and more control over the investments. This can be both good and bad depending on your knowledge of investments. Some employers will let you continue to leave your funds within the current 401k plan. This can be advantageous if you have private funds inside the account that are performing well. If you are leaving one employer and you are not yet ready to fully retire, transferring the old 401k into a new 401k has advantages if you plan on working past 70 ½. There are no distribution requirements if currently working from a current employers 401k.

Medicaid is a joint Federal and State funded program to assist the needy. It is not aged based but based on need. Example: You can be 3 years old or 78 years old. There are several levels of Medicaid assistance ranging from assistance with prescription drug costs to paying your Medicare Part B (and A) premiums and covering your medical costs that are not covered 100% from Medicare. If you are currently receiving Medicare benefits our firm can help assist you with the qualifying paperwork and help align you with the state programs you may be eligible for. If you are having problems paying for your medication, doctors or other medical treatment reach out to us, we may be able to help. Our assistance is not available in all regions, to see if we are able to assist contact us either by phone or through email. We will not share any contact information outside of our company. We do not sell your information. Below is the income breakdown for social services assistance: