D-Day, as in Medicare Part D

Well folks, the new medicare plans are out and you can prepare for a marketing avalanche from good plans and not so good plans. The big news is AARP is now co-branding a health plan, how good it is remains to be seen, but if you liked Secure Horizons, you will like the new branded AARP Medicare Choice.

Citrus County has an amazing amount of choices, and while this is a good thing for younger seniors used to making most of their own choices, it will be somewhat bewildering for older seniors. There are a whopping 58 Part D plans, 25 Health plans, and 10 Special Needs Plans. As predicted HMO's have made a comeback to Citrus County, and in a very big way. Whether you love 'em or hate 'em there are quite a few to choose from, including one that let's you use out of network doctors, and acts as a POS (Point of Service) plan.

Help for People with Limited Income and Resources
There is financial help to pay for some health care and prescription drug cost if you have limited income and resources.

Low Income Subsidy (LIS)

Medicare will help pay prescription drug costs if you have a yearly income (in 2007) below $15,315 ($20,535 for a married person living with a spouse and no other dependents) and resources (in 2007) less than $11,710 ($23,410 for a married person living with a spouse and no other dependents), for more information call 1-800-MEDICARE. People receiving a low income subsidy may qualify for reduced drug copayments, waived premiums for certain plans and waived deductibles.

The plans that would require $0 premium and deductible for a full low income subsidy are as follows: Healthnet Orange Option 1, Advantage Star Plan by RxAmerica, MedicareRx Rewards Standard, Prescription Pathway Bronze Plan Reg 11,Community CCRx Basic,WellCare Classic,First Health Part D-Premier, and Quality Rx. Remember if you receive a low income subsidy and are enrolled in a Medicare Part D plan, (not a Health Plan or Medicare Advantage), these would be your choices so you would have no monthly premium. If you have any questions please feel free to email me or call toll free 866-795-8436.

If you don't happen to qualify for a low income subsidy there are still a myriad of plans, with and without deductibles, but across the board premiums and copayments have both gone up. There has never been a better time to be using generic drugs, as many copays in plans are $0-$5, so be a smart consumer, if your doctor hasn't already put you on generic drugs, do it now. There are also a few more plans available with some type of "doughnut hole coverage". If you've been reading this blog you know that gap has changed. The hole in a standard plan begins when the enrollee's total cost of drugs reaches $2,510. You then have to pay the next $3,147 before cata- strophic coverage begins. At that point the plan will pay about 95 percent of your drug costs for the remainder of the year.

Here is a link for a donut hole calculator just input your figures. click here

I can't emphasize enough how important it is to have all the information available before you make your choices. Seek out a qualified advisor to help you make your choices based on whats good for you, not what kind of commission the advisor may make. Don't enroll in a plan because it is a good fit for a neighbor, they may have different needs than you. Don't ever be bullied into a plan that you feel isn't in your best interests.

Overseas retirement, is expat life for you?

Do you imagine yourself idling away your golden years, surrounded by pristine beauty, complete with maid service, umbrella drinks, palm trees, all for under $15 per day? The answer for a growing number of Americans making the leap into early retirement is moving to a country with a lower cost of living. The U.S. State Department estimates some 4 million Americans live abroad, not counting military and embassy folks. About a quarter of those are estimated to be retirees.

From a financial viewpoint there are some tantalizing points to consider:

• 
  In Ajijic, Mexico, a community near Guadalajara that's home to more than 3,000 expatriate Americans, where you can rent a sprawling three-bedroom, two-bath hacienda for about $700 a month.


• 
  In English-speaking Belize, where retirees don't have to pay taxes on the first $75,000 of income and where property taxes on a $500,000 home run about $90 a year.


• 
  In Spain, where the weather is good, health care is affordable and the rest of Europe is at your doorstep.

According to Money Central on MSN:

At a minimum, people who consider retirement abroad should be adventuresome, flexible, tolerant and patient, the expats I interviewed agreed.
Here are some other traits that come in handy:
You're willing to make new friends "The people who do well are couples who depend on each other a great deal," Halcomb said, "and who don't have a great sense of community or good friends they're going to miss terribly."
That's not to say you won't make new friends, particularly in areas that attract a lot of other foreign retirees.
"There are enough retired people here who are looking for friends and new acquaintances," said Chuck Svoboda, a former diplomat who retired to Spain's northern coast, "that there's no difficulty in building a fairly large circle of them in a short time."
Improved cell phone networks and Internet access also have made it easier for expats to stay in touch -- so much so, Svoboda grouses, that it sometimes "keeps people from enjoying what this country has to offer."
But you'll still be hundreds if not thousands of miles away from family and friends, who probably won't visit nearly as often as they would if you were still in the States. You may not mind watching a grandchild grow up in photos, but if you want to be there in person, overseas retirement probably isn't for you.

You're open to experiencing a new culture It seems obvious, but the rest of the world really isn't like the United States. Some people never adapt to the strangeness or to the notion that they'll always be foreigners, no matter how many other expats live in their chosen community.

You're not a Type A personality If you're the kind of person who gets impatient waiting in line at the post office, for example, then dealing with bureaucracies in other countries could drive you up a wall.
A simple banking transaction in Mexico can be an afternoon-long affair, while getting a phone installed in many countries can take months. Utilities and other bills often must be paid in person in countries with iffy postal systems -- and that means long periods standing in lines.

You have an exit strategy Regimes can change. Your health can decline. Prices can rise -- particularly if the tropical paradise you found gets discovered by lots of other ex-pats. (Of course, if you bought real estate there, it might be a good thing.)

Where are the Top 10 most desirable places outside of the US for seniors to retire?

So if you're thinking about settling down outside of the United States experts suggest you take care of some housekeeping at home before you check in at the international flights gate:
Get international health insurance.
Discuss with a financial planner the tax consequences of living outside the U.S.
Try out the new locale for three to six months. Experience the change in climate and different cultural events. Maybe it's too buggy in Central America for you or it rains in Ireland too much for your tastes.

Escape Artist is the big Kahuna of retiring overseas, browse through it's wide selection of destinations

Life's an adventure, I hope we can look further into the retiring abroad phenomenon in further posts.

You better shop around, uhuh!

´There´s some things that I want you to know now (Uh-huh-...ooo)

A just as sure as the winds gonna blow now (Uh-huh-...ooo)

The plans come and the plans gonna go now (Uh-huh...ooo)

Before you tell ´em that you love ´em so now My mama told me...´

you better shop around´ (Shop, shop around)

whoa-yeah You better (uh-huh) shop around (Shop, shop around)

apologies to Smokey Robinson

If consumers stay put in their current Medicare prescription drug plans, the average beneficiary will see a 21% increase in their monthly premiums for 2008, says new analysis released by Avalere Health.
Using newly released CMS data and its proprietary DataFrame(R) database, experts computed an "enrollment weighted" average premium for the Medicare Part D marketplace. Under this method, the premiums of plans with the most enrollees are assigned a heavier weight relative to plans with scant enrollment, giving a truer measure of the beneficiary experience. For example, a premium increase for a prescription drug plan (PDP) with 3 million enrollees carries vastly greater impact on more people than a premium increase for a plan with 10,000 enrollees.

"The reality of the Medicare experience is that beneficiaries have been very loyal thus far to their initial plan selections," said Dan Mendelson, president of Avalere Health. "If consumers stick to their choices again, they are likely to see a dramatic increase in their monthly premiums. But, consumers who shop around may be able to find lower cost alternatives."

Look out Mel Fisher! or How everyday people have found treasures on Florida beaches.

We've been far too busy and too obsessed with all things Medicare this week. So how about a daytrip. Living in Floriduh does have its benefits you know! Aside from retired folks, alligators, and hurricanes Florida is rich in TREASURE! That's right treasure of the yo ho ho and a bottle of rum type.

Many researchers and historians claim that Florida contains more buried and sunken treasures than any other state. They have also put a price tag on these treasures, which amounts to a cool $165 million ( and thats in 1964!!!!). Florida, like all other states, has a fascinating and romantic history. Seven different flags have flown over her, not to mention the black flag of the pirates. Florida became the haven of many notorious pirates, including Blackbeard, Lafitte, Gasparilla, Kidd, Rackham, Bowlegs, Bonnett, and possibly even Morgan himself. They roamed the waters of the Caribbean Sea, and captured every ship in sight. Often, they brought their loot back to Florida, and buried it on some lonely shore. When they finally died, the location of their hidden wealth died with them. The majority of all buried treasure in Florida is the work of pirates.

Florida has already yielded hundreds of lost treasures to many happy people. Among these are: A chest containing $25,000 in Mexican gold was found on Grassy Key. Miami has yielded some buried treasure. A road crew while building a new road near Cocoa found thirteen chests of treasure. $70,000 in silver coins were discovered on Lower Matecumbe Key, plus another 61 gold pieces were found by fishermen there. Dozens of pirate caches have been found on the West Coast of Florida. Millions of dollars have already been salvaged from the Spanish galleons off Florida. Some of these sunken treasures can be seen at Art McKee’s Sunken Treasure Museum on Plantation Key. This is only a small sample of what has been unearthed and salvaged in Florida.

The Story of The 1715 Spanish Plate Fleet

On July 31st, 1715 a hurricane struck the Florida coast, sinking 10 of the 11 ships that made up the plate fleet of 1715. The plate fleets carried the Quinto, or royal fifth, a 20 percent tax on gold, silver and other valuables traded in new world.
The loss of the 1715 plate fleet was probably the largest loss of treasure at sea in all of maritime history.
A beachcomber named Kip Wagner, a resident of Sebastian Creek on the Florida coast, walking the shore after a major storm discovered a coral encrusted lump of coins, all dated 1714.
At the library of congress, Kelso found a book called A Concise Natural History of East and West Florida, by Bernard Romans. Written in 1775, only 60 years after the destruction of the plate fleet of 1715, Romans had visited Sebastian Creek and learned the exact location of the wrecked fleet from the natives who lived there:
"Opposite this river [Sebastian Creek], perished, the Admiral commanding the plate fleet of 1715, the rest of the fleet fourteen in number, between this and the bleach yard"
Armed with this new information, Kip Wagner took to the sea on an inflatable tire inner tube and immediately found the 1715 fleet, their cannon laid bare by the same storm that had washed up the clump of coins he had found on the beach.
After recruiting a team of divers (including a young Mel Fisher), salvage of the wrecks began in earnest, thousand of coins and artefacts worth countless millions of pounds were uncovered by Wagner's team.
Salvage operations continue at the site to this very day.

Click here to read the story of Bob Weller and the Spanish galleon the Infante

more

$1 billion treasure hunt
A Brevard man's team battles adversity to find a 1612 galleon.

Along the East coast of Florida you can find an enormous wealth of Spanish treasure on any given beach within a 10 mile stretch of Sea Grape Trail in Vero Beach. Mike Maguire was just that lucky in 1995 when he discovered a quarter million dollars worth of 1715 Fleet jewelry on the beach near Sea Grape Trail. Vero Beach has a beach site called Corrigan's known for its shipwrecked coins that are washed up on its sandy beaches from the doomed 1715 Plate Fleet. Mike Maguire was in the right place at the right time when he discovered a 24K solid gold jewelry box on the beach. When Mike opened the box he found 5 rings and a rosary. Don't feel like getting the old metal detector out and doing the "Treasure Coast Shuffle", but still want to share in the excitement of treasure hunting? Mike MacGuire is looking for investors click..here

For the definitive webpage on Florida Treasures, Florida's Fabulous Treasures is chock full of well ....treasures see more here

Ten Overused Medical Tests and Treatments

Consumer Reports: Ten Overused Medical Tests and Treatments

— A new Consumer Reports investigation, published in the November issue, identifies 10 “Overused Tests and Treatments” and spells out how consumers can navigate a health-care system that rewards costly — and often unnecessary — tests and procedures and de- emphasizes preventive care.
The CR investigation identifies three main problems in the U.S. health- care system: unnecessary tests and treatments; costly new drugs that are often no better than the older, cheaper ones; and a glaring under-appreciation for preventive care. The investigation is the second in a series about health care. The theme of dysfunctional profit incentives was brought to light in the first installment, published in September, in which CR took note of the deteriorating ability of insurance companies to slow the growth of medical costs since 2000. The annual U.S. health-care bill, reports CR, has risen to $2 trillion, its highest point in history.Ten Overused Tests and Treatments
For consumers unfamiliar with the term “fee for service,” CR explains: Because the vast majority of doctors and hospitals are paid on a piecework basis, the more services they provide, such as blood tests, surgeries, MRIs, and CT scans, the more money they make. Experts estimate that the nation’s $2 trillion annual health-care tab is one-third to one-half higher than need be, in part because of overuse of expensive treatments and unnecessary care. CR’s overused tests and treatments are listed here, click

Medicare Gives Itself a Raise

The cost of your part B Medicare has gone up, now there's a surprise.... not! But the good news is that it wasn't raised very much. You will now be paying 3.1% more or $96.40. This increase is the smallest since 1999-2000, when the premium was at the same level, $45.50, for two years in a row. The maximum will be $238.40 a month for the most affluent, individuals with annual incomes exceeding $205,000 and each member of a couple reporting combined income of more than $410,000. For an individual with annual income from $102,000 to $153,000, the premium will be $160.90 a month.

The annual deductible for doctors’ visits and other Part B services will be $135, up from $131. The deductible was fixed at $100 a year from 1991 to 2004. It now increases to reflect the growing average cost of Part B services for beneficiaries 65 and older. For a beneficiary admitted to a hospital, the deductible will be $1,024 next year, up from $992.

Are you a Quimby? or What the heck does QMB mean?

What are some of the ways to save on part B payments?

Taking advantage of private insurers that enroll in alternatives to traditional Medicare, like HMOs. They offer rebates on all or part of the Part B premium. Details are available here soon. These plans are not the proper decision for everyone and like I've said ad nauseam consult and compare, do a needs assessment.

Are you a Quimby?

For assistance with your Medicare Part B premium, you may be eligible to have your State pay the $96.40 for you. The program is called “QMB” or “Qualified Medicare Beneficiary.”- Under the QMB program, states must pay Medicare premiums, deductibles and co-insurance for aged and disabled people with countable incomes below 100% of federal poverty levels and with countable resources below $4,000 for an individual and $6,000 for a couple. The current 2007 income eligibility limit for QMBs is $837 per month for an individual and $1120 per month for a couple.

How much will your Part D cost next year?

The premiums are going up for seniors and the disabled who are enrolled in the Medicare drug program.
The average cost will go up about 9 percent next year for stand-alone drug plans. That's according to information just released by the Centers for Medicare and Medicaid Services.
A private research firm that took a closer look at the information says most of the plans with the largest enrollment will increase their monthly premiums $5 to $10 a month. We will be finding the lowest price plans in our area and posting them. ASAP.

Elsewhere

UnitedHealth Group Inc. said Monday it launched new Medicare plans for 2008 in anticipation of open enrollment starting Nov. 15.
The open enrollment period is the period in which those eligible can sign up for or change their Medicare plans, including the Part D prescription drug program.
Among UniteHealth's offerings is a drug plan with no copay for generic drugs bought through preferred mail and plans carrying the AARP name. The company also said it is expanding is chronic illness special needs plans to 34 markets nationwide from seven.

and from the St Pete Times

What will criminals think of next? The Florida Division of Consumer Services recently issued a consumer alert about the sneaky practice of "skimming" taking place at restaurants and other places where your credit card might leave your sight for a few minutes. These tips can help you protect you. (click here)

More ABC'S and D's of Medicare,an FAQ

What are Medicare Parts A, B, C, and D?

Medicare Part A typically pays for your inpatient hospital expenses.
Medicare Part B typically covers your outpatient healthcare expenses, including doctor fees.
Medicare Part C also known as Medicare Advantage (formerly Medicare+Choice) offers a choice of options including Medicare managed care plans (like Medicare HMOs and PPOs) and Medicare private fee-for-service plans.
Medicare Part D is the outpatient prescription drug benefit resulting from the Medicare Modernization Act of 2003 that went into effect on January 1, 2006.

What if I turn age 65 and it's not during a Medicare prescription drug open enrollment period? Can I choose to enroll in a Medicare Advantage or Drug Plan?

Absolutely! When you turn age 65, you are eligible to enroll in the Medicare prescription drug plan, a Medicare Advantage plans, Medicare Supplement Plan without having to answer health questions. This is called Special Enrollment Period or SEP.

What are the options under MedicareAdvantage?

Insurance companies offering Medicare Advantage health plans must belicensed before Medicare will enter into an arrangement to purchase coverage for you. Medicare Advantage plans are based on your geographic location and are not available in all counties. The types of Medicare Advantage plans are:

• Health Maintenance Organization (HMO):

A type of managed care health plan with a defined list of providers, often referred to as a network, that enrollees must use. HMOs generally have more restrictions on the providers you may use than other types of health plans in which you can enroll, although they often provide benefits, such as additional preventive care, that are not available from other types of health plans.Normally, an HMO will make referrals to non-network providers only in unusual situations. The HMO may also require that you obtain a referral from your primary provider
before seeing a specialist. Other than in an emergency situation, an HMO will not pay for services you obtain from a provider who is not part of the HMO’s network. Before you enroll in an HMO, you should carefully review the list of providers that is available through the HMO. You should also review whether the HMO allows access to out-of-state provider networks. HMOs do notcover services provided by non-network providers that are not emergency or urgent caresituations. Typically, an HMO has only small or no copayments for covered medical services.

• POINT OF SERVICE PLAN

A type of managed care health plan with a network of providers that also permits you to use
non-network providers, usually at some additional cost to you. The POS plan may also have requirements that you obtain a referral from your primary provider before the plan will agree to pay for out-of-network care. Similar to the HMO, the POS has small copayments for medical services received from providers in the network.

• Preferred Provider Organisation (PPO):

A type of managed care health plan offered by private health insurance companies that pays a
specific level of benefits if certain providers are used, and a lesser amount if non-PPO providers are utilized. Like an HMO, a PPO operates in a certain geographic area and is limited to specific providers.

• Private Fee for Service (PFFS):

A type of health plan offered by private health insurance companies. The plan allows you to go to any health care provider who accepts Medicare assignment or participates in the Medicare program but charges in excess of the Medicare assignment amount, and who accepts the PFFS’s fee schedule. If you see a provider who does not accept Medicare assignment, you may be responsible for any charges that are up to 15 percent in excess of the Medicare allowed amount. If you see a provider who does not accept the PFFS’s fee schedule or who does not participate in the Medicare program, you will not be covered and will be responsible for the entireamount charged by the provider. The planmay charge you, through premiums, additional
out-of-pocket expenses (such as copayments and coinsurance), or both, for any costs that exceed what original Medicare would pay.

Other Medicare Advantage options you may hear about are:

• Medicare Medical Savings Account
(MSA):

A health plan option made up of two parts. One part is a high deductible health insurance policy that covers the same services as Medicare Part A and Part B. The other part is a special savings account where Medicare deposits money to help you
pay for expenses to meet the deductible. The deductible may be as high as $6,000 annually.

• Medicare Special Needs Plan (SNP):

A special type of health plan limited to people in certain institutions (such as nursing homes), or eligible for both Medicare and Medicaid, or with certain chronic or disabling conditions. SNPs are available in limited areas, and are designed to provide services to people who can benefit the most from special experts of plan providers and from care management.

Having a Senior Moment?

A Medicare Primer: Savvy Seniors maximize their benefits.

There are many milestones in a person’s life but few are more intimidating than turning 65. A magical date that transforms you from being middle aged to officially being a “Senior Citizen”, many regret that loss of status, and the stereotyping, but this can also be a time of renewal, freedom, and growth. You finally have the time to do all those things you dreamed of while you were still working, and leisure opportunities abound. If you're approaching your 65th birthday, you're about to enter the wonderful world of Medicare coverage. There are now so many choices, rules and timetables, that it can be complex and confusing. Here are a few things you should know.

When to sign up
The first thing you should know is when to enroll. Everyone is eligible for Medicare at age 65, even if your normal retirement age for full Social Security benefits is later. To avoid possible mishaps, contact the Social Security Administration -- (800) 772-1213; http://www.socialsecurity.gov/ -- three months before you turn 65 to sign up. The initial enrollment period for Medicare runs for seven months, starting three months before your birthday month and continuing for three months afterward.

If you miss your initial enrollment period for Medicare Part B, you'll have to wait until the next annual enrollment period, which runs from Jan. 1 to March 31 for benefits that begin the following July 1. There is also a penalty of 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, which covers hospital services, at any time with no penalty.


Gaps, Doughnut holes, and Medicare Advantage

Did you know that Medicare also offers a comprehensive health plan sold by private insurers called Medicare Advantage? These plans provide health-care, prescription drug coverage and additional services all in one policy, and thanks to generous government subsidies, these plans are better, cheaper and more readily available than ever before. Medicare Advantage plans are available through HMOs, PPOs, and now as private fee for service plans which allow you to use doctors and hospitals outside your network, usually at an additional cost. Some of these plans charge nothing beyond the cost of the Medicare Part B premium, which is $93.50 a month in 2007. Before deciding on the best option for you, learn about each Medicare Advantage plans offerings, and do your due diligence by comparing and speaking with a knowledgeable advisor.
If you decide to opt for traditional Medicare (Part A and B) or Fee for Service, you'll need two additional insurance policies -- supplemental medigap insurance and a Part D prescription-drug plan -- to get the same level of coverage as a Medicare Advantage plan. And Advantage plans on average are cheaper than what you would pay for traditional Medicare, a medigap policy, and a stand alone prescription drug plan.


Fill the Gaps
Should you choose traditional Medicare, it's recommended you get a medigap policy (sold by private insurance companies) to fill in the gaps that basic Medicare doesn't cover. Policies come in 12 standardized versions, labeled A through L, and cost on average about $140 per month.

Drug Coverage
Along with traditional Medicare coverage and a medigap policy, you need to enroll in a Part D prescription drug plan for drug coverage. There are tons of options offering a wide range of coverage (premiums costs average $24 per month) so choosing can be difficult.

Welcome to Senior Focus

What are we all about? Life, sharing knowledge, and fun; enriching lives through information and experience. I hope we can offer a rich balance of content that isn't boring and is timely and useful to those of us who are old enough to remember Elvis, Woodstock, and the "moonwalk" (no, not the Michael Jackson version. Although we are mostly "Florida-centric", I hope there will be information that will help people living outside of our area. We have a comments area for your thoughts, please feel free to share them with us. I look forward to the dialogue and exchange with all of you as we travel down this road together.

warmest regards

G