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Turning 65 Soon? Here’s What You Need to Know About Medicare

If you’re soon to turn 65, you will face a number of decisions related to your healthcare and Medicare enrollment. Here’s what you need to know now, so that you can start preparing for this big shift in your life.

Medicare offers you a seven-month initial enrollment window. You can enroll in Medicare during the three months before your birthday month, throughout that month, and for three months afterward. However, getting an early start is preferable, so that you have time to thoroughly research your options.

You can change your mind later. You’re not stuck with the decisions you make during the initial Medicare enrollment period. Each year, you can make changes to your plan during the Annual Election Period from October 15 to December 7. And those of you who enroll in a Medicare Advantage plan will have another opportunity to make changes, during the Medicare Advantage Open Enrollment Period from January 1 to March 31 each year.

You must enroll on time. Medicare isn’t exactly optional. You must enroll during your intial enrollment window, or else you could face higher Medicare premiums for the rest of your life when you finally do enroll.

Some people can postpone their enrollment. If you’re still employed, and your employer covers more than 20 workers with a group healthcare plan, you can delay your Medicare enrollment until that coverage ends someday. The same goes if you’re married to someone employed in such a situation, and their healthcare plan covers you.

You will face a variety of choices. Everyone who enrolls in Medicare will choose between Original Medicare (Parts A and B) or a Medicare Advantage plan, which combines Parts A and B (and sometimes includes additional provisions such as prescription coverage or dental and vision benefits). If you choose Original Medicare, you should look into your options regarding a Part D (prescription) plan, and supplementary coverage such as Medigap (which limits your out-of-pocket expense) or a dental and vision plan.

Special Needs Plans are also available to people diagnosed with certain health conditions, so that your healthcare plan can be organized around your very specific needs.

Help is free. Everyone is eligible to receive free help with researching and understanding their Medicare options. Just call us to talk to one of our brokers, and we’ll help you locate plans available in your area.

If You’re Not Enrolled in Medicare, You’ll Need This Form to File Your Taxes


Most of us don’t exactly love tax season, but many of you might feel eager to get it over with. That’s especially true if you expect to receive a refund. But before you get started, make sure you’ve received your Form 1095-A, or your proof of health insurance coverage, as required by both the Affordable Care Act and California state law. These forms are sent to individuals and families who are enrolled in a healthcare plan through Covered California or via a private insurance provider. You will need it before you can correctly file your income tax return.

First, the form details your health insurance coverage for the year, so that you can prove you complied with the law and avoid any applicable penalties. While the penalty for failing to enroll in health insurance coverage has been set at 0 dollars at the federal level, California does have its own law regarding coverage. You want to be sure to prove your status so that you aren’t at risk of any undue charges by the state.

Second, you need your Form 1095-A so that your premium subsidy (if you received one) can be correctly calculated. When the subsidy is incorrectly calculated, you could end up overpaid and owing that money back to the government. Obtaining the correct subsidy also helps you to maintain your healthcare coverage, which of course is critically important in the even that you become ill or injured.

Look for your Form 1095-A to arrive in the mail by mid-February. If you haven’t receive your form by that time, you might be able to access it by logging into your healthcare plan company’s online portal. If not, call us for further assistance and we’ll be happy to help you track it down.

Medicare Advantage Open Enrollment Begins January 1

The Medicare Annual Election Period closed on December 7, and won’t reopen until October 15, 2023. However, for those of you enrolled in a Medicare Advantage plan, you do have a second option to make changes if you decide that you need to do so. The Medicare Advantage Open Enrollment Period begins January 1 and runs through March 31, and offers all Advantage plan enrollees a second chance to consider their plans.

There are many reasons you might wish to make changes on January 1. Perhaps you’ve realized that a better plan is available in your area, or you’ve become unhappy with your network of doctors and providers. One common scenario is that a favorite physician drops out of the network, and you want to continue seeing them. Or perhaps you want to access a different clinic or hospital. Maybe you’re unhappy with your plan’s formulary (list of covered prescriptions) and need to access better coverage certain medications.

Whatever your reason, when Medicare Advantage Open Enrollment begins, you can perform the following actions:

  • Switch from one Medicare Advantage plan to another
  • Drop your Medicare Advantage plan entirely, and return to Original Medicare
  • Add a Plan D (prescription) plan to your Original Medicare, if you decided to leave Medicare Advantage

It’s important to remember that the Medicare Advantage Open Enrollment Period is only for those enrolled in a Medicare Advantage plan on January 1. This enrollment window does not apply to those currently on Original Medicare. If you want to move from Original Medicare to a Medicare Advantage plan, you will need to either wait until AEP in the fall, or qualify for a Special Enrollment Period.

If you need help understanding what you can do with regard to your enrollment at this time, or to compare different Advantage plans available to you, give us a call and we’ll be happy to review your options.



What Are My Options if I Missed the Medicare AEP Deadline?

Whoops! Medicare’s Annual Election Period (AEP) came and went, from October 15 to December 7. So what do you do, if you’ve just realized that you missed your chance to evaluate your Medicare plan options and switch to a more suitable plan? Do you have to wait until next fall, or is there something else you can do?

Depending upon your individual situation, you might have at least one more opportunity to make changes to your Medicare plan(s).

Medicare Advantage Open Enrollment Period. If you enrolled in a Medicare Advantage plan (also called Medicare Part C) but wish to change plans, you will be given the opportunity to do so during Medicare Advantage Open Enrollment, which happens from January 1 to March 31.  So if you missed your chance during AEP, hold on until January 1.  At that point, those of you with Medicare Advantage plans can take the following actions, as suitable to your situation:

  • Switch from your Medicare Advantage plan to a different Advantage plan
  • Drop Medicare Advantage and go back to Original Medicare (Medicare Parts A and B)
  • Add a Part D (prescription drug) plan, if you return to Original Medicare

It’s important to note that this enrollment period is only available to those of you already enrolled in a Medicare Advantage plan. So if you’re on Original Medicare, the Open Enrollment period doesn’t apply to you. But you do have one more option.

Medicare Special Enrollment Period. If you experience certain qualifying events, you can qualify for a Special Enrollment Period outside of AEP or Open Enrollment. These are events that would qualify you for a new Medicare plan, such as moving to a new coverage area, moving into or out of a nursing home, or being diagnosed with certain conditions which qualify you for a Special Needs Plan.

There are numerous qualifying events that can open up enrollment for you at any point during the year, so it’s best to contact your insurance broker to discuss the options available to you. We can help you analyze your situation and determine how best to proceed.

2023 Contribution Limits for HSA, FSA, and Retirement Accounts

Various benefit plans offer you the chance to set aside funds for things like healthcare expenses and retirement, while enjoying helpful tax benefits. But because the cost of living changes regularly, often due to rising inflation, the IRS and other government agencies recognize the importance of adjusting contribution limits to match economic needs. That’s good news for you, because it means you can adjust your savings strategies to keep pace with conditions now and in the future.

For 2023, new contribution limits have been announced as follows.

Health savings accounts. A health savings account (HSA) represents an opportunity for those enrolled in high-deductible healthcare plans to set aside funds for out of pocket healthcare expenses. Since these contributions are made on a pre-tax basis, you can essentially lower your taxable income for the year by the amount that you save for medical care. And you can even roll over unused funds into retirement. For 2023, the new HSA contribution limits are $3,850 for individuals and $7,750 for families.

Flexible spending accounts. Those with a flexible spending account can now contribute $3,050 to the account each year, before the money is subject to income taxes. You can use these funds to pay for uncovered medical expenses like prescriptions, copayments, deductibles, and more.

Retirement plans. And for those with an eye on the long future, don’t forget to adjust your retirement plan contributions. It’s always a good idea to max out contributions if you can, because no retiree ever said that their nest egg was too large! If you contribute to a 401k, 403b, most 457 plans, or a Thrift Savings Plan, you can now save $22,500 in your account next year. Those over age 50 can make an additional catch-up contribution of $7,500.

If you hold an Individual Retirement Account (IRA), you can contribute $7,500 to the account next year, plus an additional $1,000 if you’re over age 50.

For more information on your benefits, or to establish a benefit plan for your employees, give us a call and we’ll be happy to explain more about how these programs work.

New Medicare Sales Regulations Established to Protect Consumers

We hope you’re always able to access your Medicare benefits without any concerns, and that you’ve never felt misled about any part of your plan. But those incidents do happen, via deceptive advertising or even by accident. The Medicare program administrators are paying attention, and have released new regulations to help protect Medicare beneficiaries from fraud (whether intentional or not).

You might know that you have the right to seek free information on the Medicare plans available to you, and that these consultations often happen over the phone. But how can you be certain that the information you receive is accurate, and that no one is attempting to to take advantage of you? Medicare now requires that all phone calls regarding Medicare benefits are to be recorded. And during the first minute of the phone call, licensed brokers are required to notify you of the recording and issue this disclaimer: “I/We do not offer every plan available in your area. Please contact or 1-800-MEDICARE to get information on all your options.” That disclaimer must be mentioned within the first minute of the phone call.

The same disclaimer must also be issued when you are discussing your Medicare plan options with a broker via email or online chat.

Additionally, television advertisements, print materials, and websites must display the disclaimer language prominently, where it is noticeable by anyone who views the material.

If you discuss your Medicare plans with anyone, in any format, who does not issue this disclaimer to you, you are likely not dealing with a qualified, licensed broker. They are breaking regulations and should not be trusted. The same goes for any print materials or advertisements that you view on TV or online.

For trusted, professional guidance with your Medicare plan(s), give us a call. We are here to help you explore your options at any time. And remember, from now until December 7, the Medicare Annual Election Period allows you to compare plans and switch plans if needed.



Why You Should Consult with a Broker About Medicare Enrollment

You navigated a web of decisions when you first enrolled in Medicare at age 65. But each year, you have the opportunity to revisit those decisions and compare your current plan to other ones during the Medicare Annual Election Period. From October 15 to December 7 each year, you should discuss your current plan and any concerns with a qualified insurance broker who specializes in Medicare plans. And yes, this conversation is an important step! It’s better to consult with a broker than try to sort through these decisions alone, and here’s why…

  • You could potentially lower your out-of-pocket spending on healthcare, making retirement a bit more comfortable with regard to your budget
  • You could access a network of providers that includes your preferred doctors and facilities
  • You could lower your prescription drug costs by choosing a plan with a formulary that suits you better
  • You can gain a better understanding of how your plan works, so that you can maximize its benefits
  • You will learn how to avoid billing surprises
  • Your broker can teach you about crucial time windows of coverage so that you can avoid some of the common pitfalls
  • You might be able to avoid falling into a coverage gap
  • You can become more familiar with your plan’s customer service features, so that you are able to access help any time you need it
  • … And probably much more, depending on your needs

And the best news of all: It’s FREE to receive help with choosing a Medicare plan. No, you aren’t charged an extra premium, and you can access the exact same pricing you would access on your own. Broker commissions are already worked into the price of all Medicare plans, so if you don’t consult a broker you are technically giving up a valuable service that is already paid for.

Give us a call right now, while the Annual Election Period is ongoing, and we will help you compare different Medicare plans. You won’t know if a better plan is out there unless you investigate the options!


Medicare Premiums Will Change Next Year

Not only do Medicare plans change with regard to their coverage and drug formularies; the monthly premiums can change from one year to the next, too. Medicare beneficiaries are sometimes dismayed to learn of premium hikes, so this year we have some good news: Your premiums will actually go down a bit in 2023!

Most beneficiaries receive Medicare Part A for free, because they accumulated enough work credits in their lifetimes. So for the most part, premium adjustments apply to Medicare Part B. For most of you, the new Part B premium for 2023 will be $164.90, which represents a small decrease of just over five dollars. Your deductible will go down a bit, too, at $226 for the year.

That premiums and deductible will apply to most Part B beneficiaries, but about 7 percent of Medicare recipients pay higher premiums due to falling into a higher income tax bracket. If you’re an individual earning more than $97,000 annually, or a married couple earning more than $194,000 annually, consult with your Medicare broker. Your premiums are higher, and are based upon the particular income bracket into which you fall.

As we mentioned, Medicare Part A is free to most. But a deductible does apply to hospital stays. For 2023, your share of the hospital bill will amount to $1,600 for the first 60 days of hospitilization. If your stay exceeds 60 days, you will pay a $400 coinsurance charge between 61 and 90 days, and $800 dollars per day thereafter.

The Medicare Annual Election Period is happening now, so this is the time to investigate your plan options. Give us a call if you’re concerned about your plan’s network, drug formulary, coverage limits, premiums, or anything else. We can help you compare different Medicare plans and choose one that suits your medical needs and budgt.

Why You Should Review Your Medicare Coverage Each Year

When you turn 65 and enroll in Medicare, you might feel tempted to choose a plan and then forget about coverage decisions. But that would be a mistake, because the various options offered to you through Medicare can and will change over time! Additionally, your healthcare needs and possibly your budget will change as well. That’s why Medicare offers two different periods of time each year, during which you can make changes to Original Medicare or Medicare Advantage plans.

The first of those is the Annual Election Period, which runs from October 15 to December 7 each year. You can make changes to any Medicare plan at this time. The second, Medicare Open Enrollment, runs from January 1 to March 31 and only affects those enrolled in a Medicare Advantage plan.

So, why should you bother with these two enrollment periods? The answers are fairly straightforward.

First, Medicare Advantage plans operate on a network, and that network can change over time. Your preferred practitioners or facilities might drop out of the network, leaving you limited to whatever you are offered.

Second, your healthcare needs might change over time. You might develop certain health conditions that necessitate a Medicare Special Needs Plan (SNP), which can help you manage the costs associated with certain medical complications. Or you might simply wish you had features like dental care or vision services rolled into your plan (and some Medicare Advantage plans do offer those, whereas Original Medicare does not).

And finally, Plan D (prescription drug) plans can change from one year to the next. The plan’s “formulary” (list of covered drugs) might shift, and an essential presciption might not be covered at the same level anymore. This can become complicated if you rely on certain medications. And since most Medicare Advantage plans typically include Part D coverage, they might be affected by this type of change too.

Always read your Annual Notice of Change (ANOC) letter which arrives each fall before the Annual Election Period. This notice details any upcoming changes to your plan, so that you have time to identify your needs and switch to a new plan if necesssary.

And remember, we’re here to help. Call us with your questions about Medicare coverage, and we’ll be happy to help you sort through your options and choose a plan that works for you.

Stay Organized With These Medicare Enrollment Dates

When you reached age 65, you enrolled in Medicare for the very first time. But Medicare enrollment isn’t set for life. You have frequent opportunities to make changes to your plan(s), to ensure that your healthcare options arrangements to best serve your needs and budget.

But it can be a bit tricky to keep track of the different Medicare enrollment dates, and what you can or should do each time one of them comes up. This handy list will help you stay organized.

September and October of each year… Your Medicare plan administrator will send you an Annual Notice of Change (ANOC) letter. Read this notice carefully, because it will inform you of any changes coming to your plan for the following year. In particular, pay attention to your plan’s drug formulary (list of covered prescriptions) so that you can continue to maintain coverage for the ones you need. This is the time to compare your current plan to others that might be available to you.

October 15… This date marks the beginning of Medicare’s Annual Election Period. During this time you can drop your plan and enroll in a different one (either Original Medicare or a Medicare Advantage plan). You can also add a Part D plan to Original Medicare.

December 7… This is the deadline for the Annual Election Period. Make all changes by December 7, especially if you’ve chosen to enroll in Original Medicare.

January 1… This date marks the beginning of the new coverage year. Any changes you made during the Annual Election Period will take effect now.

January 1 through March 31… Each year, Medicare operates a Medicare Advantage Open Enrollment period. If you’ve enrolled in an Advantage plan, you can make changes at this time. You can drop your Advantage plan and go back to Original Medicare, add a Part D plan if you’ve returned to Original Medicare, or change from one Advantage plan to another. But you can’t switch from Original Medicare to Medicare Advantage at this time.

Of course, along the way even the most organized person can feel a bit overwhelmed at all of the Medicare options before them. If you have any questions or need assistance sorting through the different plans available to you, remember that free help is available to you. Just give us a call!



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