Herman Whitaker Insurance Agent

Pardon the Rant but tonight I wrote something in a response to a post and thought I should share it with more than just the one person it was intended for when I began to write. Admittedly, I have a lot on my mind these days. I seem to be in a constant state of reflection and am searching for ways to gain the wisdom needed for the next chapters of my life.

I hope you find some value in the next few lines. I hope you find a reason to pause and consider the possibilities. I would love to hear your thoughts when you finish reading the next few lines.

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Over the years, I have experienced boredom and thrills. I am experienced the plan and unexpected. One thing is for certain, when I have an event or a destination in mind, preparing for it is seldom boring. If your situation doesn't provide a solution, then begin to do some research on what is necessary not wanted. Make a list of absolutely must have's and absolutely can live without's, Put a stake in the ground, mark a date on a calendar, and don't give yourself a reason to take your eyes off the prize of accomplishment, risk and reward.

I have been on the cliff of Stupidity several times in my life. I have also been on the cliff of Panic, Despair, Frustration and Self-Doubt. However, when you begin to plan, you find yourself on the Cliff of Risk and you just need the right focus, encouragement and belief that you deserve better, can achieve more and will accomplish more when you take that next step.

Here is my simple advice, Step up to the Cliff of Risk, Dare to believe you deserve great things in life, and then take the Leap of Faith that will Change your Life Forever. It is amazing what can happen when you decide Good Enough is Simply Not Good Enough.

This is GREAT NEWS for Medicare Beneficiaries in Illinois, Nevada and Idaho.

New 'Birthday Rules' to Help Some Medigap Users Switch Plans
by Allison Bell

News December 29, 2021 at 03:42 PM Share & Print
What You Need to Know
o The Illinois and Nevada rules take effect in January, and the Idaho rules take effect in March.
o California and Oregon already had birthday rules.
o Connecticut, Maine, Missouri, New York state and Washington State have other types of Medigap plan-switching rules.
Three states — Idaho, Illinois and Nevada — are adding rules that could help unhappy Medicare supplement insurance users change policies without going through medical underwriting.
The new state birthday rules will give people who already have Medicare supplement insurance policies, or “Medigap” policies, a chance to switch Medigap policies for a few weeks every year, around the time of their birthday anniversaries.
Jesse Slome, the Director of the American Association for Medicare Supplement Insurance, put out an alert about the new state birthday rules. He emphasized, in a comment included in the alert, that Medigap users who want to switch policies should talk to insurance agents who regularly sell Medicare plans.

“This is probably one of the least-known opportunities available to seniors,” Slome said.
Getting professional advice is important, because each state has different rules, and understanding and meeting a state’s requirements is critically important, Slome said.
What the New Birthday Rules Mean

The start of the states’ new “Medigap” policy birthday rules could give insurance agents and brokers a new chance to reach out to Medigap users.

The new rules could also help insurance producers in the affected states present Medigap policies as attractive alternatives to Medicare Advantage plans.
For the affected health insurers that issue Medigap policies, the new rules will create a framework for offering plan switches on a guaranteed-issue basis, which may reduce the odds that sudden gushers of claim risk will cause some issuers to capsize.

But, because many of the plan switchers will be people with serious illnesses, hoping to get access to the best care providers for their conditions, the new rules could also add claim cost management headaches, at a time when the COVID-19 pandemic is already complicating efforts to predict and manage health care costs.
Medigap Basics
The Medicare Part A hospitalization program pays hospital bills, and the Medicare Part B program pays outpatient and physician services bills.

Relevant Resources
Medigap policies can help consumers pay their Medicare Part A deductible and meet the traditional Medicare copayment and coinsurance requirements.
Consumers can also buy Medicare Advantage plans. Those policies tend to offer enrollees broader coverage than the traditional Medicare program, in exchange for giving the enrollees financial incentives to use in-network providers and requiring the enrollees to get preauthorization for some medical procedures.

Call me or send me a message to learn how this may benefit you as a Medicare Beneficiary. I am here to help.

Medicare AEP vs OEP

EP stands for Medicare Annual Enrollment Period and OEP stands for Medicare Open Enrollment Period. Depending on the context, OEP can refer to many other Medicare enrollment windows.

Difference Between Medicare AEP vs OEP

The Annual Enrollment Period otherwise referred to as AEP, is the time of year when a Medicare beneficiary can make changes to their current coverage. This enrollment window runs from October 15th to December 7th. Each September before AEP begins, the plan benefit changes for the next year are released, allowing Medicare beneficiaries to look around to ensure they are electing the plan that best fits their needs.

With Medicare Advantage and Part D plan benefits changing every year, premiums could increase, benefits can be changed, and prescription drug formularies can be changed.

Every year in September you will receive an Annual Notice of Change (ANoC) letter. This letter explains all the changes that will be affecting your plan in the upcoming year. The AEP gives you a chance to change if you are not happy with the future adjustments to your plan.

What You Can Do During the Medicare AEP

• Drop an Advantage Plan and return to Original Medicare
• Elect to change from one Advantage plan to a different one
• Change from Original Medicare to an Advantage plan
• Elect to change from one Part D prescription drug plan to another
• Cancel your current Part D plan
• Pick up a Part D plan if you currently do not have one

Any changes you make during the AEP will go into effect on January 1st of the following year.

What Can I Do During the Medicare Open Enrollment Period?

This depends on what OEP you’re referring to. If you’re talking about the AEP, then you can make changes to your current Medicare Advantage or Part D plan.

Those referring to the Medicare Advantage Open Enrollment Period can only make changes if they’re already enrolled in a Medicare Advantage plan.

If you’re referring to your Medicare Supplement Open Enrollment Period, then you can enroll in a Medigap plan without having to answer any health questions.

It’s important to note, you can enroll in a Medigap plan at any point during the year.

The only difference is if you do it outside your open enrollment window, you’ll have to answer health questions.

How Many Changes Can I Make During the OEP?
Again, this depends on what Open Enrollment Period you’re referring to. If you’re making changes to your Advantage or Part D plan during the AEP, you can make as many changes as you want. The last change you make is what will stick and become effective January 1st of the following year.

If you’re referring to your Medigap OEP, you can also make as many changes as you want. Whichever plan you choose last is what plan you will be enrolled in. It will become effective the 1st of the following month, or as soon as your Part B is active. If you choose to make another change, and you’re still within your 6-month open enrollment window, your plan will become effective on the 1st of the following month.

If you’re talking about the Medicare Advantage Open Enrollment Period, you can only make one change during this enrollment window. So choose wisely the first time!

How to Get Help Understanding the Medicare OEP vs AEP

Due to the confusing enrollment windows and choices you have with Medicare, it's recommended that you speak to a licensed insurance agent that specializes in Medicare.
I am here to help. Please feel free to reach out to me for answers to your questions.