This Happens: Retired Corporate Employee

This Happens

A gentleman is turning 65 years old in the autumn.  One day, we happened to meet (as I meet many people who are going to turn 65 years old in the near future).  After a very short while, it was clear to me that he was well-informed about Medicare, and well-aware that his particular location had higher Medigap rates than others in the nearby area. The gentleman informed me that he was retired from a large, well-known Fortune 500 company. Coincidentally, I was aware of this particular company, and its specifics. 

Our Converstaion (the gist)

Me: That company's retiree health benefits were substantially worse than the private market alternatives. 

Him: Yes, I am well aware of this fact. I am researching the alternatives.

Me: What did you do when you were at the company?

Him: I was directly responsible for employee benefit plans.

Bottom Line

The world is competitive, and companies have one constituency: shareholders. They are the owners. Retirees? Well down the line among those interested parties. I am sorry, but that is the financial reality in this global economy. Even this gentleman knew that his company's retiree health benefits could be replaced with a private plan which would be superior than his company's. And he is right.

This Happens

The best thing a retiree can do is to NOT assume anything. This is your new vocation. Medicare represents the intersection of two of your most important assets, your health, and retirement savings. The example above illustrates why you should not presume that your former employer will take care of you; while I hope that is the case, circumstances may dictate otherwise.

Responding to the Reviews

Dialogue Please
"They" say you are not supposed to respond to reviews, positive or negative.  "They" are usually wrong.  At the risk of rubbing someone the wrong way, here goes.

"Best guide out there." "First strategic book." "Well worth the money."
These were the objectives.  These are the objectives.  These will be the objectives. I priced the book for the everyday reader, well below its financial value, well below the price of other books that "explain" Medicare. I wrote it with scenarios to illustrate the effects, both intended and unintended. If you want to accept risk on your own, I am not against this. You may have good reason, and it isn't my role to tell you what to do. My role in this discussion is to lay out the choices clearly, so that you are not surprised by the results of the risks that you unintentionally take, if and when they occur. I wrote this book to help a senior (and his/her family) avoid the consequences that he/she did not intend, or did not understand in advance.

"Preachy"
This is a description that I did not expect. If anything, I haven't even come close to describing what can happen if you ignore the information in the book.  Let me put it simply: bankruptcy is a real possibility if you leave Medicare alone unchecked, become ill, and require extensive medical treatment with prescriptions. If you live alone, with no family, then that may be fine since you will be the only person to experience the consequences. For the remainder, it is now your vocation to know Medicare.  Period.  My part of this covenant? I guarantee that a reader will recover the price of the book, every year.  Send me the book back, and I will donate the copy to a group that will benefit, and I will refund your money.  Myself.

"Not Much New"
If you are experienced in Medicare matters, and have knowledge of all the options, and can compare them side-by-side, with family scenarios in mind, then you are right.  This book is not for you.  The preface to the book is "I know everything there is to know about Medicare. Said by no one."  If you are that 0.01%, then send me the book back, and I will donate the copy to a group that will benefit, and I will refund your money.  Myself.


"Don't Buy the Kindle Version"
You need to read the beginning of the book.  It is quite clear: I advised readers to READ THE GLOSSARY FIRST. It is a fact of life that there is specialized language in every profession or practice. Ask a lawyer, ask a physician, ask a plumber: jargon is everywhere. The reviewer does admit that the terms are explained. When technology improves on ebooks generally, you will be able to click on a word, and up will come the definition from the glossary. We are not there yet. We will be in the future.


"Incomplete"
I cannot comment on certain practices in certain states. I should not comment on services by governmental agencies, or groups funded by the government.  If you didn't see the news at all over the past two weeks, the government is watching, to put it mildly. Kidding aside, this is not a political book with political aims. For that you can read the Obamacare Survival Guide.  Most importantly: even when rules apply, you can get inconsistent answers from governmental agencies. I have dealt with the situation on behalf of my professional clients, and it takes a long time and persistence to undo this type of situation. The book only comments on the most blatant cases. This is intentional. If you believe that there is an omission that could benefit future readers, email me please!

Help me
If I knew then what I know now about book publishing, Maximize Your Medicare would not exist at all, for better or worse. Indiegogo is a platform for crowdsourcing, and is used to raise money to be used for objectives.  My objective? Overcome hurdles inherent in book distribution. You most likely found the book on amazon.com or at your local library. In other words, there are many, many others out there that require this information, and I need to reach them.  And I need your help. $10,000 sounds like a lot, and it is. Candidly, it is about 50% of what is required to do the job correctly. That is how high the barriers to entry are for a single book. There is a very low probability of recovering this amount, given that it is as $10 book, and there are middlemen everywhere.  So, if you found the book helpful, or acknowledge that there are countless others that would benefit, please help me by clicking on the widget below.

This Happens: Misinformation from Commission on Aging

This Happens

A retired woman, in her late 70s, receives a notice from her existing retiree group plan, which she is entitled to as a result of her marriage (which is now effectively ended).  The notice tells her that she needs to select a prescription plan option.  She calls her local Commission on Aging.  

Commission of Aging Misinformation

The person at the Commission of Aging inputs her prescription information and presents her with Part D options.  The problem: the notice the woman received was for her to select a prescription plan option within her group plan, not a stand-alone Part D plan.  The result: the woman is ejected from her group plan, and no longer has medical coverage, other than original Medicare.  The reason for this is that the Medicare system does not allow more than one prescription drug plan.  

Maximize Your Medicare Can Help

It is important to avoid these situations before they occur.  It is an unfortunate circumstance, and this article is not an indictment of the Commission on Aging in general.  Maximize Your Medicare has many examples of these types of instances, ones that you (or someone you know) may face.

This Happens: Medicare Advantage Cost Sharing Worse Than Original Medicare

Medicare Advantage Plans Are Approved by the CMS

Every year, Medicare Advantage plans of all types are approved by the Center for Medicare and Medicaid Services (CMS).  Every plan must be at least as good as original Medicare, i.e. those plans which include prescription drug benefits needs to be at least as good as Medicare Part A, Part B and Part D.  

"At Least As Good" Means....

Here is the issue.  When the CMS approves plans, these plans must be at least as good as original Medicare, which is defined as the actuarial equivalent.  What does that mean?  It means that statistics are used to determine that the Medicare Advantage plan is at least as good as original Medicare, on average.  That does NOT mean that your Medicare Advantage plan is better than original Medicare for each particular benefit.  You can (rightfully) ask:  What in the world does THIS mean?

Example: Skilled Nursing Facility Care

I am not going to point out insurance companies; it is not the point of the blog, or the book Maximize Your Medicare, to point out specific companies or specific policies.  However, here is a real-world example.

Original Part A Skilled Nursing Facility Care:

0-20 days:  $0.  Medicare pays.

20-100 days:  You pay the first $148 per day in 2013, Medicare pays the remainder.

100+ days:  You pay 100%

Medicare Advantage Example:

0-20 days:  $50/day copay.

20-100 days:  $150/day copay.

This Happens

If you stay at a skilled nursing care facility for 100 days, it is entirely possible that you will pay $1160 more than under original Medicare.  

Get Maximize Your Medicare, Get Informed

These small details seem insignificant, right?  Tell that to the subscribers of this plan in 2013, who are admitted to a Skilled Nursing Facility. I cannot fix this, and neither can you, other than to become informed every year, to check every year, to protect yourself to the best of your ability.  

You want $9.99 of value?  There it is, free, and there are many, many more examples of this in Maximize Your Medicare.

Why "Quick Guides," "Idiot's Guides" Don't Work For Medicare

Maximize Your Medicare is Not a Glorified Ad
Simply put yourself in my place: I am not allowed by law to offer a product to readers through this book. One needs to consider the writer/sponsor of a publication, which may be an advertisement disguised as an information guide. You may have received pamphlets, and they are not necessarily factually incorrect, but they are not necessarily complete, either.

Seniors are confused, NOT "Dummies" or "Complete Idiots"
I think that titles like "Complete Idiot's Guide...." or "...for Dummies" are insulting. In Maximize Your Medicare, jargon is explained in plain-spoken English, even though I am academically and professionally qualified to speak in jargon. "Quick" guides can't work, and the stakes for Medicare-eligible persons is way too high for me to simply say "do this," or "do that."  People's situations are different, and must be thought through independently. Real-life examples called "This Happens" provide illustrations of what has happened to others.

Medicare and the Fiscal Cliff

Even in the Best Case, Medicare Will Probably Get Weaker

As reported in Kaiser Health News here , there are a number of ways that the Medicare system can change given the negotiations around the "fiscal cliff."  None of them seem to be positive.  This is the fiscal reality in which we all live.  Lower payments to providers (physicians, hospitals), higher Medicare eligibility age, and weakening Medigap benefits are some of the ideas that the article mentions.

Maximize Your Medicare Prepares You

We cannot predict the changes that will occur.  We cannot directly control Medicare policy.  Maximize Your Medicare helps prepare you for what can happen, and how you can think about this today.  What we can do is to plan appropriately, given the rules that we are given.  Maximize Your Medicare is written with this in mind, so that you will know how to adjust your benefits plan to fit the changing landscape.

Group Retiree Health Benefits Require Thought

Annual Enrollment is Occuirng at Employers

From now through the middle of December, employers have been sending out health benefit prices and alternatives to both active and retired employees.  Unfortunately, the calendars being provided require some thought under duress, because there isn't much time to decide.  For many Medicare beneficiaries, this means just staying with the existing plan.  That is not a very good idea.

Group Benefits Getting Weaker

Almost certainly, the book which describes the benefits for 2013 are weaker, either because the price is higher, or the coverage isn't as good as it was in the past.  Maybe you will shrug your shoulders, and just say "That's the way it is."  Maybe this is correct.  BUT, maybe not.  Medicare beneficiaries should check their actual schedule of benefits and compare it to the plans in the private market (Medicare Advantage / Medigap).

Maximize Your Medicare Shows You How

Maximize Your Medicare goes through the steps of how to understand the benefits provided by your employer.  It illustrates examples of how retirees should look at the private market, and compare for themselves.  In addition, it also illustrates the consequences when you do not consciously think about the matter.  No one will do this for you: not the human resources department, and not your ex-colleagues from work.  Maximize Your Medicare will inform you on how to approach your individual situation.

Misleading Tweets Hurt Medicare Beneficiaries

Tweets Like This Do More Harm Than Good

Disclaimer:  I support Twitter and use it actively.

Tweets like this can be found everywhere.  

http://t.co/pIdiFAXN Virginia seniors get full coverage #Medicare ala $59.95/mo @MedicareWire #UHC #aarp Check out this post

First, it is NOT TRUE.  This ad leads to a policy which does not provide full coverage.  Not even close.  Second, tweets such as this may lead Medicare beneficiaries to believe that this is the correct price for the market, and these messages set unrealistic expectations.
"Hey wait, I saw on the internet that full coverage costs only $xx.xx a month."
Now, the cycle of unrealistic expectations, suspicion of insurance companies, and distrust of Medicare begins.  That is decidedly negative.

Maximize Your Medicare Isn't Free, and Shouldn't Be

You know the phrase "You get what you pay for?"  The problem with free information is that it places no responsibility on those that provide the information to you.  That is a statement in the defense of licensed agents.  There is a reason for them: regulations govern their activities, and the penalties are severe.  If you are misinformed (and can prove it), you may be able to appeal and change your Medicare option.  Maximize Your Medicare is designed so that you are informed, and can identify the traps of misleading tweets, and weaknesses in the "free" information available.  

This Happens: Retiree Told Wrongly By Social Security Administration About Medicare Eligibility

This Happens

Active employee has stayed with his wife's retiree health insurance group plan, which was superior to his at the time that he turned 65 years old.  He decides to forego enrolling in Medicare Part B.  All good so far.  She then turns 65, and there are no retiree health benefits offered to her at that time, so she enrolls in Medicare Part B (with no problem).

The man then immediately (no lapse in coverage) goes to his own employer's group plan, again without enrolling in Medicare Part B, because there is no such requirement.  However, after one further year of working, he then decides to retire, and the employer's retiree health benefit plan is worse than Medigap.  He then correctly chooses Medigap.
A week after the 1st date of Medicare eligibility, he is sent a letter by the Social Security Administration office, which informs him that he is not eligible for Medicare Part B, and must wait for the General Election Period, and his Medicare Part B effective date will be July 1, 2013.  At that point, he will also be assessed a penalty for 2 years. 

This is completely, utterly wrong.  If both the wife's plan and the husband's employer plans constitute creditable coverage, then the husband is eligible to enroll for Medicare Part B at anytime, for up to 63 days after cancellation of his employer's group health plan.  He has been misinformed by the Social Security Administration.

Bottom Line:  The Social Security Administration is NOT the same thing as Medicare.  SSA decides on eligibility;  Medicare decides on benefits.  If you do not agree with the determination made by the SSA, then you can go to another office in your area and get another opinion.  This Happens.

 

This is a true example:  Maximize Your Medicare goes through many situations, all called "This Happens," so that you are properly informed, and can secure the coverage and benefits according to current law.