GET CONTRACTED
Edward@Croweandassociates.com
Call us: 1.203.796.5403
Crowe & AssociatesCrowe & Associates
  • Home
  • ABOUT
  • Sales Blog
  • Sales Tools
    • Online enrollment
      • Connect4Medicare
      • Sunfire
    • Quote and comparison site
    • Application Processing
    • Free Medicare lead program
    • Agent website
    • Predictive dialer
  • Free Leads
  • Products
    • Medicare Plans
    • Life Insurance Plans
    • Final Expense Insurance
    • Long Term Care Insurance
    • Fixed and Indexed Annuities
    • Healthshares
    • Dental and Vision Plans
    • Other Products
  • Training Webinars
  • Contact Us

Blog

Home 2017 March
Medicare Employer Information Form

Medicare Employer Information Form

By Ed Crowe | General Articles | 0 comment | 27 March, 2017 | 0

Medicare Employer Information Form

Medicare Part A Coverage –

Are you working and Medicare eligible with insurance either through your own or your spouse’s employer?  If this is the case, you should consider taking Medicare Part A (hospital Insurance).  In most instances, there is no cost to you for the extra coverage Part A provides.  We have included a link at the bottom of the page with the Medicare Employer Information Form.  This form helps both you and your employer start your Medicare Part A coverage.

Should you take Medicare Part B coverage?

Before you sign up for Part B coverage there a few things you need to be aware of.  First of all, Part B is medical insurance, this coverage is not free and you will be charged a monthly premium.  You also need to know; when you are Medicare eligible your employer insurance may change to some extent. Check with your human resources department or benefit coordinator so they can explain any changes in coverage or concerns you have. You will also need to double check insurance information with the Social Security Administration and Medicare.

Health insurance is very important to us all.  You don’t want to make mistakes with your healthcare coverage, as that could be costly.  Each person has different needs, therefore it is entirely up to you to decide what coverage is best for you.  You also have to decide if the costs will be reasonable with regard to your coverage needs.

Primary and Secondary Insurance –

In fact, if you have primary insurance coverage with your employer, most likely you do not need Part B. If you are not satisfied with the coverage your employer provides, you may want to think about Part B coverage.  If you choose to add Medicare Part B to your employer insurance you need to find out which insurance will be primary and which one secondary.  Primary insurers will pay your approved medical claims first.

Secondary insurance will normally pay the part of your expenses left over after the primary has paid.  The amount secondary insurers pay can be either all or some of the unpaid balance. This amount may be the remaining 20% of the doctors fee after primary has paid.  If you are not enrolled in a primary insurance plan, but only a secondary plan, you will have little to no coverage.  When employer insurance becomes secondary you may be better off if you take Medicare both Parts A and B.

 

Enrollment Period

Medicare offers a Special Enrollment Period without penalty when you first qualify for coverage.  You may enroll in Medicare, without penalty, at any time while you have group health coverage. This enrollment period is also good for eight months after you lose your group health coverage or you (or your spouse) stop working, whichever comes first.

Sometimes your employee coverage will automatically move into a Medicare Advantage Plan (private health plan).  If you have health coverage from either a union, a current or a former employer when you become Medicare eligible.  You can keep the Medicare  Advantage Plan or switch to either Original Medicare or a different Medicare Advantage Plan.  You should know that if you switch plans, Your employer or union could lessen or even terminate your health benefits or the benefits of your dependents.  Discuss any healthcare plan changes you may want with your employer or union to make sure your coverage is safe.

Click the link below for the employer medicare Forms.

Employer Medicare Forms

Medicare Savings Program Connecticut

By Ed Crowe | General Articles | 0 comment | 20 March, 2017 | 0

Medicare Savings Program Connecticut

Crowe and Associates wants to help you sort through some of the information on the Medicare Savings Program Connecticut.

Medicare Savings Programs are designed to help Medicare recipients by paying the Part B costs for them.  Although Part A is no cost to most people, if the recipient or their spouse has not worked long enough to qualify for this benefit then,  the MSPs (Medicare Savings Program), may pay the Part A cost for you.  MSP will also pay for the monthly part B premium which everyone pays for.  Your income must be within a certain range in order to qualify for the MSP.  There are 3 types of Medicare Savings Plans available, each one is based on the recipients income level.

The income limit amounts will remain in effect through March 2018.  We have listed the three plans that are available below:

CLICK HERE FOR MSP BROCHURE

Medicare Savings Program Connecticut: First Plan:

QMB – This plan is for only people who qualify as Medicare Beneficiaries and meet the income criteria as stated below.
Qualified Medicare Beneficiaries (QMB) – There are no asset limits on this plan.
QMB income limits (211% FPL):   If you are a single person with income of $2,120.55 or less per month.
If you are a Married couple with income of $2,854.83  or less per month.

This plan pays not only premiums for Medicare Part A  and Part B but also deductibles and co-insurances as well.  It will also pay for drug plan premium up to the benchmark plan premium, provided coverage in the coverage gap and limit drug copay costs.

Medicare Savings Program Connecticut: Second Plan:

SLMB, this plan is solely for people who meet the following criteria:

SLMB or (Special Low Income Medicare Beneficiary) income limits: (231% FPL) – There are no asset limits on this paln.
If you are a single person with income of $2,321.55 of less per month.
If you are a married couple with income of $3,125.43 or less per month.

This Plan will pay only Medicare Part B premiums.  It will also pay for drug plan premium up to the benchmark plan premium, provided coverage in the coverage gap and limit drug copay costs.

 

Medicare Savings Program Connecticut:  Third Plan:

ALMB is also called the Q4.  This plan has limited funds, therefore it is only available until the funds are exhausted. This is not an entitlement program and applications can only be accepted while there are funds available.  ALMB, (Additional Low-Income Medicare Beneficiary)  programs also have no asset limit
ALMB income limits (246% FPL):
If you are a single person with income of $2,72.30 or less per month.
If you are a married couple with income of $3,328.38 of less per month.

This Plan will pay only Medicare Part B premiums.  It will also pay for drug plan premium up to the benchmark plan premium, provided coverage in the coverage gap and limit drug copay costs.

TO VIEW QMB vs MEDICADE COVERAGE CLICK HERE

If you would like more information about any of these programs please contact Edward Crowe at Crowe and Associates either by phone at (203)796-5403 or by email at Edward@croweandassociates.com.

FOR FAQs CLICK HERE

FOR CT MSP APPLICATION CLICK HERE

Medicare Part D Enrollment Penalty

By Ed Crowe | Medicare | 0 comment | 8 March, 2017 | 0

Medicare Part D Enrollment Penalty

How much is the Part D penalty?

The cost of the Medicare part D enrollment penalty depends on how long you go without Medicare Part D or creditable prescription drug coverage.

Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($35.63 in 2017) by the number of uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest 10 cents of your Medicare Part D monthly premium.  The national base plan premium usually increase each year, so your penalty amount may also increase each year.

Here is an example of how the Medicare part d enrollment penalty works:

Mrs. Jones is now eligible for Medicare, and her Initial Enrollment Period ended on May 31, 2013. She doesn’t have prescription drug coverage from any other credible source.  She decided to join a drug plan during the open enrollment period for a 1-1-16 start date. Her drug coverage was effective January 1, 2016.

2016

Since Mrs. Jones was without creditable prescription coverage from June 2013–December 2015, her penalty in 2016 was 31% (1% for each of the 31 months) of $34.10 (the national benchmark premium for 2016) or $10.57. The penalty is rounded to the nearest 10 cents so she would pay $10.60 a month for a penalty.   Her current prescription rx plan would include the penalty premium amount with her regular plan premium.

Here’s the math:

.31 (31% penalty) × $34.10 (2016 base beneficiary premium) = $10.57

$10.57 rounded to the nearest $0.10 = $10.60

$10.60 = Mrs Jones monthly late enrollment penalty for 2016

Keep in mind, Mrs. Jones may pay a higher penalty the following year if they raise the benchmark premium for 2017

 

How do I know if there will be a Medicare part D enrollment penalty?

After you join a Medicare drug plan, the plan will tell you if you owe a penalty and what your premium will be. Most people will have to pay this penalty for as long as you have a Medicare drug plan. The exceptions would be for those that drop coverage or are approved for a drug help program such as MSP.

What if I don’t agree that I have a penalty?

You may be able to ask for a “reconsideration.” Your drug plan will send you a letter explaining how to appeal.  All appeals will be sent to a company called Maximus that will review appeals.  Maximus is the only company that can review them. As a result, you will need to wait until they make a decision. You must do this within 60 days from the date on the letter telling you that you owe a late enrollment penalty. Also send any documentation that supports your case.

Do I have to pay the penalty even if I think it is wrong?

You must pay the penalty until a decision has been made on the appeal. Failure to pay the penalty could result in termination of your enrollment.

How long does it take to decide on the appeal?

In general, Maximus (Medicare contractor) has 90 days to make a decision.

What happens if Maximus decides the penalty is wrong?

If Maximus decides you should not have a penalty, they will send you a letter stating that fact.   Your drug plan will then stop charging you the penalty and will send details regarding a refund of the penalty amount you already paid.

What happens if Maximus decides the penalty is correct?

They will send you a letter stating the penalty is correct. You will be forced to continue paying the penalty if you want to maintain you drug coverage.

Do you have a Medicare supplement plan (also called Medigap)?  If so, a high deductible plan F supplement may be a way to save money compared to your current supplement plan. CLICK TO LEARN ABOUT HIGH DEDUCTIBLE F PLAN SUPPLEMENTS

High Deductible Plan F

By Ed Crowe | Medicare Supplements | 0 comment | 3 March, 2017 | 0

High Deductible Plan F

High Deductible Plan F can save substantial amounts of money on a yearly basis compared to a Medicare supplement plan F, G or N.  The following description will detail how the plan works and why it is often a better option for seniors.

What is a high deductible plan F?

A high deductible plan F is a Medicare supplement plan (also called a Medigap plan).  It has the same benefits as a standard plan F supplement but with a $2,200 deductible prior to having the coverage of a traditional plan F.  Once the deductible is satisfied, the high deductible F covers exactly the same as a plan F.  The benefit of the high F is the reduced monthly premium which can be up to 80% lower than the standard plan F premium.  Because high F is a standardized supplement, there is no provider network.  Medicare supplements do not have networks.  You may go to any doctor that accepts Original Medicare.

How does the deductible work?

The high deductible Plan F deductible does not work the same as a traditional high deductible plan.  Medicare A and B roughly covers 80% of approved services.  The 20% left over is the only amount that goes toward the deductible.  The common misconception is the insured needs to pay the first $2,200 of services which is not the case. In fact, most people enrolled in the high F plan do not meet the deductible on an annual basis.  The key is to understand what Medicare A and B covers which will provide a better understanding of what charges will go toward the high F deductible.

How much money can be saved on a high F plan?

The savings is in the reduced premium.  There is also additional savings when the annual deductible is not met.  Premiums vary by state.   We will use Connecticut as an example.  In Connecticut, one of the lower cost plan F supplements is $239 a month. One of the lowest cost high F plans in Connecticut is $53 a month which creates a substantial savings.

Plan F premium = $239 a month x 12 months = $2,868 annual premium.  This premium will be paid regardless of how often the plan is used.

High deductible plan F = $53 a month x 12 months = $636 annual premium.  This is a difference in annual premium of $2,232.   In the event the full deductible was hit for the year, the total plan cost would be $2,836 ($636 annual premium + $2,200 deductible paid).  When the deductible is met, the annual savings is marginal but the deductible is not often met for the year.

How often does the average person meet the $2,200 deductible?

The high deductible plan F works so well because the deductible is not often maxed out.  Here are some national averages to consider.

85% of people age 65 to 67 spend $541 a year toward the $2,200 deductible.  Remember that Medicare A and B is providing coverage at 80% of Medicare allowable charges and only 20% goes toward the deductible.  As a result, this will provide a total annual savings of  $1,691 using the high F plan vs. the standard F plan.

80% of people age 68-72 spend $647 a year toward the $2,200 deductible.  This would be a savings of $1,585 using the high F vs. the standard F plan

70% of people age 73+ spend $754 a year toward the $2,200 deductible creating a savings of $1,478 a year.

Those that do manage to spend $2,200 for the year will be no worse off than if they had a regular plan F.  Maxing the deductible plus the annual premium still has them spending less than the total annual cost for a standard plan F. The benefits are the same once the deductible is met for the year.

What happens if I meet the $2,200 deductible for the year?

If you do meet the $2,200 deductible for the year, your plan will pay all Medicare approved claims. It will work just like a regular plan F. The insurance carrier will track all costs and will pay your claims automatically if you have accumulated costs up to $2,200.  Everything is automated, without the need to submit any type of paperwork.  Note: Please be sure to use a carrier that provides automatic claims filing.  Using a carrier that does not auto file claims may require you to submit paper forms for claims to be paid.

What if I decide I want to go back to my old supplement?

In  CT, NY and some other states, you are allowed to change supplements the 1st of any month the entire year.  If you try the high deductible plan F and don’t like it, you can change back to your old plan F, G or N any month you like.  The change is guaranteed and can not be blocked due to health conditions in guaranteed issue states.  The process to change back is quick and simple.

Next steps

Call our office to discuss further at 203-796-5403 or email Edward@croweandassociates.com

CLICK FOR MORE DETAILS ON MEDIGAP HIGH F PLAN

 

High Deductible Medicare Supplement

By Ed Crowe | Medicare Supplements | 0 comment | 2 March, 2017 | 0

High Deductible Medicare Supplement

High Deductible Medicare Supplement is usually the best option for a Medigap plan if the premium is low enough. The biggest challenge is understanding how the plan works and why it will prove to be a better choice than standard supplements such as F, G and even N.

If you are willing to pay out of pocket for certain health care costs and if your state has a well priced high F plan it could be your best option. A high-deductible Medigap plan F can offer substantial premium savings while still providing dependable coverage. Premiums on high deductible Medicare supplement plan F can run up to 75% less than plan F and G supplements. As with any other supplement, high deductible Medicare supplement plan F still provides access to a huge number of providers because Medicare is still the primary insurance.

How does the High deductible Medicare supplement plan work?

We need to start with an understanding of how high deductible Medicare supplement plan F works. A high-deductible Medicare Supplement Plan F pays the same benefits as a standard medigap Plan F. Its the same only after the insured has satisfied a calendar year deductible. For 2017 the deductible is $2,200. In other words, the $2,200 represents the max out of pocket you pay prior to having full coverage just like a regular plan F.

Out-of-pocket expenses are those expenses not covered by Original Medicare. It is important to keep in mind the deductible is only for the expense that Medicare approves but does not pay all of.  The insured does not pay the first $2,2,00 of medical services.  You only pay the approved services that Medicare does not pay all of such as deductibles, copays and cost shares. 

As an example, assume you have a Medicare eligible expense that costs $5,000 (Medicare approved amount which is usually much less than the provider charges.) Typically, Medicare will cover 80% of the approved charges which in this case is $4,000. This would leave the insured paying $1,000 of the charges.  The $1,000 would then be put toward the $2,200 deductible of the high deductible Medicare supplement plan. As a result, there would be a potential to spend $1,200 more out of pocket for the calendar year. If there is another $1,200 of costs, the plan will cover 100% of the remaining Medicare approved services for the year.

Examples of how a high deductible Medicare supplement work using real premiums

Lets use a real example from NY. One of the lower cost high deductible Medicare supplement plans in NY cost $64.00 a month.  $64.00 x 12 months is $768 in annual premium.  If you max out the $2,200 for the year it will be a total cost of $2,968 for the year.  One of the lower cost plan F supplements in NY (example is for the city, boroughs, Westchester county and LI) is $269.50 a month.   For 12 months that would total up to $3,234 in annual premium.  As you can see, the high F plan will be less even if the full deductible is met.

How much does the average senior spend toward the deductible in a year?

The big savings is when you do not meet the annual deductible.  Here are some averages:  85% of seniors age 65 to 67 spend an average of $541 annually toward the deductible.  80% of seniors age 68 to 72 spend an average of $647 annually toward the deductible. 70% of seniors age 73+ spend an average of $754 a year.   As a result, the averages favor the person enrolled in the high F plan saving substantial amounts of money every year.  If someone does have a bad year and meets the deductible they will still save some money no matter what.

A high-deductible Plan F will almost always provide a savings for those enrolled in it vs. a plan F. The trick is understanding how the plan works. Also, being able to pay any larger sums that may occur early in the policy year.  In some states, such as NY and CT, the insured can switch from one supplement to another. They can do this the first of any month throughout the year.  Health underwriting is not allowed so you can not be blocked due to health conditions.

How much does Medicare A and B cover and how much will I be left to pay toward my deductible?

Medicare part A is the hospital inpatient part of coverage.  There is a deductible for $1,316 for inpatient stays on part A.  Part B is 80% coverage after the deductible of $183 (annual).  Use the link to see other costs that will accumulate toward the deductible on A and B. Click for A and B benefits and cost share

Do you want to see the premiums for other Medicare supplements such as F,N,G,L and K?

Benefits for supplements in most states are standardized by plan. This means the benefits are the same regardless of which company is offering it.  For example, a plan F has the same benefits no matter who offers it. An example of rates is provided.  We are using Connecticut Medicare Supplement rates as an example here.  CLICK FOR CT MEDICARE SUPPLEMENT RATES

Are you an agent/broker looking to offer a high deductible Medicare Supplement to your clients?  CLICK HERE TO LEARN MORE ABOUT HIGH F PLAN SALES

Want a quote for the lowest cost high deductible Medicare Supplement in your state

Call our office to receive a quote over the phone (203-796-5403) or email Edward@croweandassociates.com  

Categories

  • Ancillary Health product sales
  • Annuities
  • annuity
  • Brokers
  • CD rates
  • Dental
  • Dental insurance
  • Disability
  • FDIC insured CDs
  • Fixed interest rates
  • General Articles
  • Group Health Insurance
  • Individual Health Insurance
  • Investments
  • Latest news
  • Life Insurance
  • Life Insurance Products
  • Long Term Care
  • Medicare
  • Medicare A and B benefits
  • Medicare Advantage Plans
  • Medicare compliance
  • Medicare Drug Coverage
  • Medicare Supplements
  • Over The Counter benefits
  • phone and home Medicare sales
  • Retirement Income
  • Voluntary Benefits

Recent Comments

  • Peggy Webb on Humana OTC catalog 2024
  • Adam on What Are Medicare Rapid Disenrollments
  • marilou macdonald on Anthem OTC catalog
  • APRIL WEST on United Healthcare OTC catalog 2024
  • Debra on Humana OTC catalog 2024

Social Icons

Archives

  • May 2025
  • April 2025
  • March 2025
  • February 2025
  • January 2025
  • December 2024
  • November 2024
  • October 2024
  • August 2024
  • July 2024
  • June 2024
  • May 2024
  • April 2024
  • March 2024
  • February 2024
  • January 2024
  • December 2023
  • November 2023
  • October 2023
  • September 2023
  • August 2023
  • July 2023
  • June 2023
  • May 2023
  • April 2023
  • March 2023
  • February 2023
  • January 2023
  • December 2022
  • October 2022
  • September 2022
  • August 2022
  • July 2022
  • June 2022
  • February 2022
  • December 2021
  • October 2021
  • February 2021
  • January 2021
  • February 2020
  • January 2020
  • October 2019
  • July 2019
  • June 2019
  • May 2019
  • April 2019
  • March 2019
  • February 2019
  • January 2019
  • October 2018
  • September 2018
  • August 2018
  • July 2018
  • April 2018
  • March 2018
  • February 2018
  • January 2018
  • December 2017
  • November 2017
  • September 2017
  • August 2017
  • July 2017
  • June 2017
  • May 2017
  • April 2017
  • March 2017
  • February 2017
  • January 2017
  • December 2016
  • July 2016
  • June 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • January 2016
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • May 2015
  • March 2015
  • February 2015
  • September 2014
  • August 2014
  • May 2014
  • April 2014
  • March 2014
  • February 2014
  • January 2014
  • September 2013
  • August 2013
  • July 2013
  • June 2013
  • May 2013
  • April 2013
  • March 2013
  • February 2013
  • January 2013
  • December 2012
  • November 2012
  • October 2012
  • September 2012
  • August 2012
  • July 2012
  • June 2012
  • May 2012
  • April 2012
  • March 2012
  • February 2012
  • September 2011
  • July 2011
  • June 2011
  • April 2011
  • August 2010
  • April 2010
  • September 2009
  • August 2009

Recent Posts

  • Understanding IEP vs ICEP
    16 May, 2025
    0

    Understanding IEP vs ICEP

  • What is an SPAP SEP
    15 May, 2025
    0

    What is an SPAP SEP

  • What are Part B Excess Charges
    14 May, 2025
    0

    What are Part B Excess Charges

  • Success Strategies For Medicare Agents
    14 May, 2025
    0

    Success Strategies For Medicare Agents

With licensed sales professionals in both the investment and insurance fields, the experienced and knowledgeable team at Crowe & Associates can tend to your various needs.

Latest News

  • Understanding IEP vs ICEP

    Understanding IEP vs ICEP

    As a Medicare agent, mastering all the different enrollment periods is crucial

    16 May, 2025

For agent use only.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800 MEDICARE to get information on all options.

Not affiliated with the U. S. government or federal Medicare program. This website is designed to provide general information on Insurance products, including Annuities. It is not, however, intended to provide specific legal or tax advice and cannot be used to avoid tax penalties or to promote, market, or recommend any tax plan or arrangement. Please note that [Agency Name], its affiliated companies, and their representatives and employees do not give legal or tax advice. Encourage your clients to consult their tax advisor or attorney.

Follow Us

  • Follow Us on LinkedIn
  • Find Us on Facebook
  • Watch Us on YouTube

Subscribe to our newsletter

Edward K. Crowe & Associates LLC BBB Business Review
  • Home
  • About
  • Agents
  • Quote
  • Retirement
  • Services
  • Blog
  • Contact
  • Privacy Policy
Copyright 2025 Crowe & Associates | All Rights Reserved |

Insurance Agency Website by Stratosphere

  • Home
  • ABOUT
  • Sales Blog
  • Sales Tools
    • Online enrollment
      • Connect4Medicare
      • Sunfire
    • Quote and comparison site
    • Application Processing
    • Free Medicare lead program
    • Agent website
    • Predictive dialer
  • Free Leads
  • Products
    • Medicare Plans
    • Life Insurance Plans
    • Final Expense Insurance
    • Long Term Care Insurance
    • Fixed and Indexed Annuities
    • Healthshares
    • Dental and Vision Plans
    • Other Products
  • Training Webinars
  • Contact Us
Crowe & AssociatesCrowe & Associates

Online Enrollment- Enroll prospects online without the need for a face to face appointment. Access to all major carriers with the ability to compare plan benefits and prescription drug costs. Link to recorded webinar https://attendee.gotowebinar.com/recording/2899290519088332033

All agents receive a personalized enrollment website. Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. Agents are credited for all enrollments. Click Here

Error: Contact form not found.