Guardian Healthcare Medicare Advantage Bankruptcy - What To Do About It?

Posted by J. Garrett Ball, Medicare specialist on January 18, 2011 under Uncategorized | Be the First to Comment

Recently, the Medicare Advantage company, Guardian Healthcare, filed for bankruptcy. Because Guardian is, as of 2010, one of the top three Medicare Advantage plans in SC, this filing affects many individuals in the state who have this Guardian Medicare Advantage plan, as well as providers and agents who are owed money by the company.

Regarding the Guardian Healthcare members, the most important thing to note is that the Centers for Medicare and Medicaid Services (CMS) has declared a special election period for many affected members of this health plan in most counties in the state. For those people who have been granted this “SEP”, they will be (or have recently been), notified by a letter from Medicare. Make sure you hold on to this letter. This “SEP” allows those who have Guardian Healthcare’s plan the opportunity to chose either an actual Medicare Supplement plan (also called Medigap) or another plan.

Although health care reform and other changes have greatly affected the number and quality of Advantage plans that are available, there are still a few Medicare Advantage plan options in the state (3 companies that are operating Advantage plans in the whole state). However, as an independent agency, our recommendation would be to use this one-time special enrollment period to choose a Medigap plan. The advantages of a Medigap plan (vs. an Advantage plan) are listed below:

• First of all, Medicare Supplement plans don’t change each year, like Advantage plans do. The plans are Federally-standardized, so each company offers the same outline of coverage for their plans - the only variation is price and company reputation.
• Secondly, Medigap plans, unlike all Advantage plans (as of 1/1/2011), do NOT have networks. Someone who has a Medigap plan can go to any doctor or hospital nationwide that takes Medicare.
• Lastly, Medicare Supplement plans offer a “Guaranteed Issue” into a Medicare Supplement when you are involuntarily losing your Medicare Advantage plan (i.e. Guardian Healthcare). If you have any pending health issues or history of medications or health problems, you have this one-time opportunity to qualify for a Medicare Supplement without medical underwriting or pre-existing condition restrictions.

Overall, the bankruptcy of Guardian Healthcare has been, and will continue to be, a problem for many affected members, providers, and other affected groups. However, for members, because Medicare has granted this SEP, which allows you to choose a new plan without penalty or underwriting, you can take advantage of this one-time opportunity to either select the more comprehensive coverage of a Medicare Supplement plan or find a new Advantage plan.

To get more information about either, please visit South Carolina Medicare Supplements or call us at 877.506.3378.

Medicare Supplement Insurance - Five Things 90% of Seniors Going on Medicare Don’t Know

Posted by J. Garrett Ball, Medicare specialist on June 17, 2010 under Uncategorized | Be the First to Comment

Medicare Supplement insurance is something that everyone that goes on Medicare has to understand. Even if you have employer insurance or are electing to have only Medicare, you still must understand these supplements and the ramifications of having/not having one in order to make an informed decision on whether to get one, and if you are getting one, exactly which one to get. When looking at these supplemental plans, there are a few things to keep in mind that, from our thousands of conversations with individuals going on Medicare, we’ve realized that many seniors going on Medicare simply do not know. For your reference, we’ve listed a few of those things below:

1. Medicare Supplement plans do not cover prescription drugs.
   Prescription drugs are covered under Medicare Part D NOT Medicare Supplement plans. Since supplemental plans are standardized (see #4 below), NO plans can offer drug coverage as a benefit to their supplemental plan.
2. Medicare Advantage plans are NOT Medicare Supplement plans. The two are completely different.
   Many seniors make the small terminology mistake of calling Advantage plans “supplement” plans. This is simply not true. Advantage plans do not supplement Medicare; on the contrary, they replace Medicare and ALL benefits are provided through the private company. With a true supplement plan, you still have Medicare A & B, you just have a supplement to fill in some, or all, of the ‘gaps’ in Medicare.
3. Medicare Part D (Rx coverage) has a “donut hole”. This applies to all plans and there is no way to avoid it completely.
   The Medicare Part D “donut hole” is one of the most troublesome (to many people) parts of Medicare, and unfortunately, there are no ways to avoid it completely. The best way to reduce your prescription drug costs are to ensure that you are on a Part D plan that most thoroughly covers your medications and re-evaluate this on an annual or bi-annual basis.
4. Medicare Supplements are Federally-standardized and they are portable across state lines.
   All companies must offer the exact same standardized Medicare Supplement plans. There is no variation among these plans. A Plan ‘F’ with one company is the exact same as a Plan F with another. Also, all Medicare Supplements can be used anywhere in the U.S. - there are no restrictions or networks. As long as a doctor/hospital takes your primary coverage (Medicare), they will take your supplemental coverage.
5. Medicare Supplement rates change over time. All plans go up in rate and there is no way to avoid that entirely.
   Regardless of what a company or agent may tell you, all Medicare Supplement plans do go up over time. There is simply no way to avoid this. They may go up at different time periods or using different methodology for increases, but overall, all companies are going to go up. And the best counsel is to have a plan that is the lowest cost possible when signing up (since plans are standardized).

Secure Medicare Solutions is a leading, independent brokerage that works exclusively with Medicare insurance. You can get a Medicare Supplement quote by visiting Medigap Quotes or Medicare Supplement Quotes. You can also reach us by phone, if you prefer, at 877.506.3378.