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Health Tips and Information


Health Insurance Enrollment Deadline Rapidly Approaches

As the deadline to enroll in an individual or family health insurance plan rapidly approaches, we wanted to take a moment to remind you of what you need to do.

The deadline for health insurance Open Enrollment is January 31. You must sign up for a healthcare plan, or you might miss your chance for the rest of the year (more on that in a moment). And, since California now enforces its own statewide version of the Individual Mandate, you might be subject to a penalty if you don’t have healthcare coverage in 2020.

This deadline applies to individual and family healthcare plans only. It does not apply to Medicare plans, or to group health insurance plans (those offered by an employer).

What you should do during Open Enrollment. Contact your health insurance professional for help with comparing different healthcare plans available in your area.

You might qualify for a subsidy to help with the cost of your premiums. Make sure to provide the appropriate financial information so that your subsidy can be calculated.

Or, if you already qualify for a subsidy, you should update your financial information to ensure that your subsidy can be recalculated for 2020.

If you like your current plan and want to keep it, review the details to be sure it’s still a good fit for you. Sometimes changes in coverage occur from one year to the next, and you shouldn’t assume that your plan will continue to fit your needs perfectly.

In some cases, you can enroll in a healthcare plan outside of Open Enrollment. If you experience a qualifying life event, such as a move or change in family structure, you can enroll in a plan or change to a different plan outside of the usual Open Enrollment window. However, since you can’t count on one of these events occurring, it would be wise to go ahead and enroll now.

Remember, the deadline for health insurance coverage is January 31, so get started today. Give us a call and we can help you determine the next steps you should take.

What to Do if You’re Turning 65 This Year

About ten thousand Baby Boomers turn 65 each day, meaning around 3,65,0000 will reach that milestone during 2020. That’s over three-and-a-half million people who will now become eligible for Medicare, and yet many aren’t yet sure what they’re supposed to do. So, if your 65’th birthday is rapidly approaching, this brief Medicare enrollment primer might help.

If you claim your Social Security benefits… You will be automatically enrolled in Part A coverage, which is free for most people, and you will have the option to enroll in Part B coverage (for a monthly premium).

If you aren’t claiming your Social Security benefits yet, you will need to take the initiative to enroll in Medicare. You will not be automatically enrolled, so it is very important to remember the following time frame.

You’re eligible to enroll in Medicare during a seven-month period. You can start the enrollment process at any point during the three months before your 65’th birthday, during your birthday month, or for three months afterward. If you miss this initial enrollment window, you could face higher premiums when you do enroll. So mark this deadline on your calendar. Contact your local Social Security office, or apply online at

Decide if you want to enroll in Medicare Part D. Part D, or prescription drug coverage, is available to those who are concerned about the cost of current or future prescriptions. You will pay a monthly premium in exchange for managed prices on many common drugs.

Research Medicare Part C, or Medicare Advantage Plans. Instead of enrolling in Medicare Parts A and B, you can opt for a Part C plan (also called Medicare Advantage plans). These comprehensive plans roll Parts A and B into one healthcare plan, and many also include Part D coverage. These plans are available for a premium, but the type of coverage offered might be more convenient or affordable for you in the long run.

As with any other healthcare plan, what’s right for one person won’t be perfect for another. So you should carefully compare Advantage plans before determining whether this option better suits your needs.

We can help with this part. If you’re interested in Medicare Advantage plans, give us a call and we’ll discuss your needs. Then, we can match you with a plan and review the details with you.


What Can You Do if You Missed the Medicare Open Enrollment Period?

Medicare’s annual open enrollment period just ended on December 7. If you missed the deadline, you might be wondering if you’re stuck with your old plan until next October 15, when enrollment opens again. Fortunately, there are a few situations in which you can still make changes to your Medicare plan(s).

Medicare Advantage Open Enrollment Period (MAOEP). From January 1 to March 31, those who are enrolled in a Medicare Advantage plan can switch to a different Advantage plan if desired. Or, you can drop Medicare Advantage entirely, and go back to Original Medicare. However, before dropping your Advantage plan, keep in mind that you’ll lose the benefit of an out-of-pocket spending cap on approved medical services, because Original Medicare does not have one. You might also lose access to your network of providers.

The main thing you can’t do is move from Original Medicare into an Advantage plan at this time.

Switch to a five-star Medicare plan. Medicare plans are rated each fall. If you’re not enrolled in a five-star plan, you can move into a Medicare Advantage Plan, Medicare Cost Plan, or Medicare Prescription Drug plan between December 8 and November 30. You can only switch plans once, and you must select a five-star plan in order to make a change.

Consider a Medigap plan. Certain Medicare Supplement Insurance Plans, or Medigap plans, will allow you to purchase coverage outside of the regular annual enrollment period. Eligibility depends upon numerous factors and is subject to underwriting approval, so discuss this issue with your insurance professional to see if this is a viable option for you.  However, even if it is, this could affect your prescription drug coverage and you could be subject to a penalty when enrolling outside of the Annual Enrollment Period.

Medicare Special Enrollment Period. Certain life changes will allow you a Special Enrollment Period, during which you can make changes to your Medicare plan. If you move, lose access to certain insurance coverage, have an opportunity to enroll in a new form of coverage, or your plan changes its contract with Medicare, you might be eligible for a special enrollment period. Certain other situations also quality you to make changes outside of the usual enrollment period. You can learn more about those here.

If you find yourself dissatisfied with your Medicare plan outside of the annual enrollment period, give us a call. We can discuss your concerns and investigate whether one of the above options might provide a solution for you.


The Surprising Benefits of Dental and Vision Care

The benefits of dental and vision care seem obvious: You can keep your teeth and gums healthy, obtain corrective lenses if you experience vision problems, and detect any early signs of diseases of the eye. But the benefits of regular dental and vision screenings actually don’t stop there.

During a simple checkup, your dentist or eye care professional can detect early signs of many serious diseases. In fact, over 90 percent of systemic diseases present symptoms in the mouth, and many produce changes in the eyes as well.

For example, the following conditions manifest certain symptoms related to your eyes, often at an early stage of the disease:

  • Diabetes
  • High blood pressure
  • Thyroid disorders
  • Arthritis
  • Several types of cancer
  • High cholesterol
  • Certain tumors
  • Multiple sclerosis
  • Sickle cell disease

In addition, if you’re becoming susceptible to a stroke, certain signs of that risk might show up in your eyes.

In a similar fashion, many diseases are associated with oral symptoms. For example, certain bacteria in the mouth are associated with heart attack risk. During a routine exam your dentist might discover early signs of the following conditions:

  • Diabetes
  • Leukemia
  • Pancreatic cancer
  • Oral cancer
  • Heart disease
  • Kidney disease

In the event that your eye care professional or dentist notice something amiss, they won’t formally diagnose you with one of these conditions. They will, however, advise you to visit your primary care physician to double check on these symptoms, to see if they are related to a more serious disorder. Since most of us tend to rely upon annual exams to discover the development of chronic illness, staggering dental checkups and eye exams throughout the year can be a good way to stay on top of your health. You’re more likely to discover serious conditions in an earlier stage of development, when they are more easily treated.

Some health insurance plans don’t offer coverage for dental and vision care, but anyone can enroll in a supplemental (extra) policy. Give us a call about dental and vision insurance, and we can help match you to a plan that suits your needs.


5 Last Minute Open Enrollment Tips

The Open Enrollment season for health insurance is in full swing, but some of you probably haven’t gotten started yet. That’s okay, but keep in mind that with the holidays rapidly approaching, you might run short on time later. In California our Open Enrollment lasts from October 15 to January 31, but you must sign up for a plan by December 15 if you want coverage to start January 1.

So, how do you get started right now? Just follow these simple tips.

Step One: Make a short list of your priorities. Do you prefer to remain with a favorite healthcare provider? Do you have any health conditions for which you require medication or specialized care? Are you at risk of developing such a condition, and want to cover your bases just in case? Do you value certain types of care over others? Which healthcare facilities are convenient for your location and schedule?

Step Two: Analyze your family structure. Are you single, married, or married with children? Do you plan to add a child to your household in the next year (whether through pregnancy or adoption). Changing household structures can drastically alter your priorities, so make sure you’ve considered things from that angle.

Step Three: Consider your budget. A low-deductible plan will cost you a higher monthly premium, whereas a low-premium plan will come with a higher deductible. You should consider how much you can realistically afford each month, keeping in mind that you might be eligible for a subsidy that helps you cover at least part of your premiums. Consider, too, whether you have upcoming medical expenses, or if you’re unlikely to even meet your annual deductible (although no one can ever know this for sure).

Step Four: Consider other money-saving options. If you do opt for a higher-deductible plan, consider whether a health savings account (HSA) might be a good fit for you. You can save pre-tax dollars for use toward healthcare expenses (like your deductible) and any unused funds in the account can be rolled over to the next year.

A flexible spending account (FSA) allows you to divert pre-tax money into an employer-owned account, to be used for out-of-pocket healthcare expenses. However, you could lose the money if you don’t use it all by the end of the year, or change employers.

Step Five: Investigate plans. In California plans will differ depending upon your county. After you log into the Covered California system, or as you work with an insurance professional who can show you your options, it’s time to to compare the plans in the pricing tier you’ve chosen. Ask questions regarding the priorities you set in step one, so that you can identify the plan that best suits your preferences.

We can help you evaluate your budget, and then match you with a plan that suits your needs. Give us a call, and we’ll get started today. Remember, the deadline for coverage that begins January 1 is December 15. Let’s take care of this before Thanksgiving, so you won’t have to worry about it for the rest of the year.




4 Ways to Cut Your Medicare Expenses

For most of us, healthcare will be one of our largest expenses in retirement. According to Fidelity, the average 65-year-old couple retiring today can expect to spend $285,000 on healthcare over the course of their retirement years. For single retirees, the estimates range from $135,000 (for men) to $150,000 (for women).

It’s no wonder most retirees are eager to learn ways to cut back on their expenses in this area. The following strategies can help you reduce Medicare spending to some degree.

Mark the deadline on your calendar. You can sign up for Medicare beginning three months before your birthday, extending to three months after your birthday month. Usually, if you’ve claimed your Social Security benefits this step will be done for you. But check to be sure; if you miss the sign-up window, you will pay higher premiums due to a late penalty.

Plan retirement income carefully. Taxable income in a higher tax bracket can trigger Medicare premium increases. That’s why many retirees work with financial advisors to establish non-taxable forms of income, such as distributions from a Roth IRA.

Shop around. Depending upon your needs, a Medicare Advantage plan might work better for you than Original Medicare. But the premiums can be equal to Part B premiums, or up to about 100 dollars per month more. Comparing the cost versus benefits can help you decide which plan is right for you. In some cases, a more expensive plan is actually worth it in the long run (but not always).

Don’t stick with the same plan forever. As your healthcare needs change, your Medicare plan should change too. Each fall, during the annual open enrollment period, you have the opportunity to evaluate different types of coverage. If you don’t make any changes, your current plan will renew. But you could miss an opportunity for savings if you allow that to happen.

We can help you compare the costs of different plans, and understand their unique benefit offerings. Give us a call now, so that we can evaluate your needs and help you enroll in the right Medicare plan for you. Remember, the annual open enrollment period for Medicare plans will end on December 7. Let’s get started today.

Medicare Premiums and Deductibles are Changing in 2020

Each year, Medicare administrators analyze the system’s coverage and budget, and issues changes to certain plan components. Usually this means incremental increases in premiums or deductibles. In most cases these changes are not significant, but it can be important for retirees to keep up with them so that you can adjust your own financial plans for the year.

Coming in January 2020, Medicare will issue changes to Part A and Part B deductibles, and to Part B premiums.

Deductibles increase in 2020. The deductible refers to the healthcare expenses that you will pay out of pocket, before your plan covers the rest for the year. In 2020, Part A deductibles will rise from $1364 to $1420.

Part B deductibles, on the other hand, will increase from $185 to $197 annually.

Between Part A and Part B deductibles, you should expect to spend an additional $68 dollars next year ($56 plus $12), assuming you seek enough healthcare through both plans to reach those limits. It’s not a huge difference, but you should plan your annual budget accordingly.

Part B premiums. Most people do not pay a premium for Part A, but Part B premiums can and do change periodically. For most Medicare beneficiaries, Part B premiums will rise from $135.50 to $144.30 per month next year – an increase of $8.80.

That’s not an enormous difference, and for most retirees the increase will be covered by the cost of living adjustment which is due to Social Security beneficiaries. In 2020, the 1.6 percent COLA will amount to about 23 dollars for the average Social Security check.

But because Part B premiums are deducted from Social Security checks, a lesser-known rule might prevent some beneficiaries from seeing the entire Part B premium increase. That rule states that Part B premium increases cannot outpace raises to Social Security benefits. So, if your own COLA falls below $8.80, your Part B premium increase will be limited to the amount of your COLA.

If any of this information is confusing, please give us a call so that we can clarify. We can help you figure out what to expect from Medicare changes in 2020, and help you plan ahead.

A Special Benefit Opportunity for Smaller Companies

Most employers recognize the importance of offering a group benefit plan to their workers, but for smaller companies the idea can seem out of reach. The cost of premiums, participation minimums, and other regulations can present some obstacles. That’s because normally, a health insurance plan might require a minimum number of members in order to achieve group status, and regulations regarding contributions can strain employer budgets.

The small group special enrollment period was designed with these challenges in mind. During this annual time period, from November 15 to December 15, smaller employers can establish a group health insurance plan without the burden of these restraints.

How could the group special enrollment period help your company? During this time

  • employers aren’t required to make premium payments, and
  • you can establish a group plan as long as at least one person enrolls

Additional benefits. The cost of premiums for health insurance is often cited as the primary reason so many smaller companies (and their employees) abstain from a health insurance plan. One provision can help your company and workers overcome that obstacle. By making pre-tax premium payments through payroll deductions, employees can lower their income tax liability while also covering premiums for their healthcare plans.

As for those premiums, employers are not required to contribute to them. But if you decide to do so, you can contribute as little or as much as your budget allows. As your company grows, you can adjust your benefits packages accordingly.

Finally, your employees retain their options as well. If they prefer to remain on a plan offered through the Individual marketplace, or shop for a private insurance plan, they can do so.

Remember, in order to obtain coverage that begins January 1, enrollment must be completed by the deadline of December 15. For more information on starting a group health insurance policy for your company, please call us and we’ll help you get started.

Mark These Medicare Enrollment Deadlines on Your Calendar

Many people imagine that once they reach age 65, choosing a healthcare plan becomes as simple as signing up for Medicare once. Then, they believe they won’t ever have to think about it again. Unfortunately, that scenario doesn’t exactly match up with reality. But if you mark these dates on your calendar and plan around them, making decisions regarding healthcare doesn’t have to be overly complicated.

Your original enrollment period… You will become eligible for Medicare three months before the month in which you turn 65. This period extends for that entire month, and then for three months afterward. You must sign up for Medicare during this time, if you don’t want to face a late enrollment penalty later (in the form of higher premiums for the rest of your life).

Those who have already claimed their Social Security benefits will be automatically enrolled in Medicare Parts A and B (or Original Medicare) when they turn 65. But if you have yet to claim Social Security, you need to remember to take this step on your own.

If you continue to work past age 65… Make sure you sign up for Medicare within eight months of leaving your group health insurance plan, or within eight months of leaving the job, in order to avoid the penalty.

Every year, you will make decisions during an enrollment period… The Annual Election Period runs from October 15 to December 7 each year. During this time, you can switch from Original Medicare to an Advantage plan, from an Advantage plan back to Original Medicare, or from one Advantage plan to another.

You can change your mind… If you enroll in an Advantage plan and change your mind for any reason, you can change plans from January 1 to March 31 each year.

If you have questions about your Medicare coverage, enrollment periods, or the different plans available to you, give us a call. We can help you compare your options and know what to expect from your healthcare plan in retirement.


Health Insurance Affordability Expands in California

Since the Affordable Care Act revamped the health insurance marketplace as we once knew it, legislators have instigated various changes at both the state and federal level in order to keep pace with “growing pains” within the new system. Our marketplace here in California, called Covered California, has received praise for expanding healthcare coverage to millions of Californians who otherwise would not be able to afford a policy.

We have accomplished this goal by offering health insurance subsidies to those in lower income brackets, to help them afford monthly premiums. Subsidies were based upon those provided by the federal government, as described by the ACA.

However, coverage rates still have yet to reach 100 percent, and some middle income Californians were unable to take advantage of the subsidy program. In an effort to extend coverage to even more state residents, our legislature passed the State Individual Mandate and Penalty, which goes into effect on January 1, 2020.

Under the mandate, coverage under an approved healthcare plan is now mandatory, and enforced by a penalty for each uncovered household member. This penalty will amount to $695 per uncovered adult and $347 per child, or 2.5 percent of the household income (whichever is greater).These penalties will be assessed when you file your state tax return, and are paid to the state.

However, the state is also extending subsidies so that more Californians can afford their health insurance premiums.

Now, those who earn up to $75,000 (for individuals) or $150,000 (for a family of four) can also receive a premium subsidy from the state. These income caps are calculated to fall at 600 percent of the federal poverty level. Check with a licensed insurance representative to discover whether your family is eligible, and for a calculation of your estimated subsidy based upon your household income and family size.

Keep in mind that this law is different from the federal Individual Mandate, which has not been overturned, but for which the penalty was set at 0 dollars. Californians don’t have to worry about being doubly penalized for failing to enroll in health insurance. But, with premiums now more affordable for extended income brackets, we expect to see enrollment increase this year.

In order to comply with the new law, make sure to select a health insurance plan during Open Enrollment this year (November 1 through December 15). If you have questions about the state mandate law, or want to learn more about state-provided subsidies for health insurance, please contact our office and we’ll be happy to assist you.




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