Margy Wenham Insurance Services, Inc - Serving California Since 1991

Age-Attained Rating Medicare supplement insurance companies set their own monthly premiums, so costs will vary from company to company.  Most base their premium on your age at the time the policy is signed or issued and where you reside.  Invariably, you’ll receive a small rate increase each year as you age, often less than $10.00 a month. The insurer also has the option to increase your premium annually due to other factors like inflation.  Most major carriers don’t have dramatic annual rate increases; however, be wary of a few insurers that initially offer an attractive rate but dramatically increase it the next year.  How can you avoid policies that have dramatic rate increases?  Seek an agent that represents multiple major insurance carriers and understands historical premium rate trends. The insurance companies that have dramatic rate increases are often promoted by aggressive agents.  These agents often solicit Medicare Supplement polici...

Medicare is preparing to stop using Social Security numbers for identification next year and will send new cards to patients with Medicare ID numbers. Using Social Security numbers has been a recognized vulnerability for years, exposing seniors to identity fraud. In a digital society, having a Social Security number stolen can have immediate financial and legal consequences taking months and even years to untangle. The move is required by a law enacted two years ago to discourage identity theft. The Centers for Medicare & Medicaid Services (CMS) will to begin mailing the new cards with Medicare beneficiary identifiers (MBIs) in April, 2018. That's when the agency will begin mailing out new cards to more than 57 million elderly and disabled beneficiaries. They'll be instructed to destroy their old cards after they get the new one. New cards may be used right away.  No final prototype of the new card has been unveiled, but the MBI will have 11 characters, a combination...

California has just completed another successful open enrollment season and the percentages of those who are uninsured have dropped to 7.1% - a record low in our state. As a health insurance professional in California, I understand the importance of quality health care coverage and affordability of that coverage.  That is why I'm compelled to write this blog entry. The California Senate is presently seeking to abolish private health insurance in California, along MediCal, Medicare, Covered California, and the valuable advocacy services of health insurance professionals.  Under Senate Bill (SB) 562 ALL Californians will lose their current benefit plans, to be replaced by benefits yet to be determined, to be serviced by an entity yet to be identified, to include new tax provisions yet to be detailed.  This would be disastrous for all Californias.  A bill of this magnitude has too many unanswered questions and Californians cannot afford "to pass it to find out wha...

Because of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, Medicare Supplement Plan F will no longer be sold starting in 2020.  Congress decided to do away with plans that fully cover all deductibles.  Plan F (presently the most popular plan sold) covers all of Medicare’s deductibles and co-pays. The elimination of Plans F (and C) are thought to decrease claims and ease the financial strain on Medicare. The theory is that if a Medicare recipient doesn’t have to pay anything for a doctor visit, they’ll see a doctor more frequently.  On the contrary, if Medicare recipients become more responsible for their out-of-pocket medical expenses they’ll see their doctor less. While Medicare’s actual cost-savings from this change can’t be calculated, it is “projected” to save billions each year.  If You Have Plan F Prior to January 1, 2020 You Can Keep It Indefinitely If you have Plan F when January 1, 2020 comes around you don’t have to do anything...

When choosing a Medicare Part D Drug Plan (usually during the annual Open Enrollment Period and between October 15th – December 7th) most do so based on their current medications.  Frequently, however, over the course of the plan year medications are added or dropped.  Consequently, a plan that once covered each of your medications may not later.  Are you then stuck until the next Open Enrollment Period?  Not necessary.  Initially, the simplest approach may be to ask your doctor to prescribe another medication. Talk to Your Provider Often, there are many medications that achieve the same objective of your physician.  If a drug isn’t covered ask your doctor for an alternative medication.  If there isn’t an alternative drug available, then consider seeking a “drug formulary exception.” Formulary Exceptions and Plan Determination Requests An enrollee through his doctor can request a drug plan formulary exception to cover a medication. These exce...

There aren’t any significant changes in the Medicare Supplement (Medi-Gap) Plans in 2017; however, that doesn’t mean cost savings aren’t available to those willing to shop coverage. While the Medicare Supplement Plans are standardized, meaning a Plan F for example from AARP will have the identical coverage as a Plan F from Anthem Blue Cross, rates can vary widely.  This can mean Medicare recipients can be paying, in some cases, 50% more than is available with another company.  Additionally, while almost all Medicare Supplement plans rates increase each year due to inflation and increasing overhead costs, not all company’s annual increases rise by the same percentage.   Generally, and on the average premium cost rise 3-5% annually.  Occasionally, however, some carriers have a rate increase as high as 15 to 20%. Because rates can vary tremendously between Insurers the least expensive or “best buy” on a policy one year may not be the next.  Cons...