Uncategorised

{articletitle}

If you have Original Medicare (Parts A and B) due to a disability and you are no longer considered disabled, your Medicare coverage may change. Here are some key points to consider:

  1. Loss of Disability Status: If the Social Security Administration (SSA) determines that you are no longer disabled, your eligibility for Medicare based on disability will end. However, you may still qualify for Medicare based on age once you turn 65.  
  2. Extended Coverage: After you are no longer considered disabled, you may still receive Medicare coverage for a limited time. Typically, you can continue to receive Medicare for at least 93 months (about 7 years and 9 months) after your disability benefits end. 
  3. Purchasing Medicare: If you lose your premium-free Medicare Part A because you are no longer disabled, you may be able to purchase Medicare Part A and continue to pay premiums for Part B if you choose to keep it. 
  4. Alternative Coverage: If you lose Medicare coverage, you might need to explore other health insurance options, such as employer-sponsored insurance, Medicaid, or plans available through the Health Insurance Marketplace. 

{articletitle}

January 1st to March 31st is the Medicare Advantage Open Enrollment Period, previously known as the Disenrollment Period.

Open Enrollment Period MA or MAPD enrollees have the option to:

  • Switch to another Medicare Advantage plan (with or without drug coverage). 
  • Return to Original Medicare (Part A and Part B) and, if desired, enroll in a Medicare Part D prescription drug plan

This period allows your clients to make changes to their Medicare Advantage coverage, but they cannot enroll in a Medicare Advantage plan for the first time during this period. For first-time enrollment, they would need to use the Annual Enrollment Period (October 15 to December 7) or their Initial Enrollment Period.

During the OEP, do not:

  • Send beneficiaries unsolicited communications about the ability to make any additional changes or reference the MA OEP.
  • Target, by way of purchased mailing list or any other means, any beneficiary who’s in the MA OEP because they made a decision during AEP.
  • Participate in or advertise any agent/broker activities that address the MA OEP as a means of making more sales.
  • Contact former enrollees who chose a new plan during AEP.
  • Use the MA OEP as an excuse to reach more clients you didn’t get to see during AEP.

For more detailed information, click the button below to download our flyer outlining the important aspects of the Medicare Advantage Open Enrollment Period.

Download the OEP Flyer

{articletitle}

In Pennsylvania, PACE (Pharmaceutical Assistance Contract for the Elderly) and Extra Help are not the same, but they both aim to assist with prescription drug costs.

PACE is a state program that helps qualified residents aged 65 and older get prescription medications at a lower cost. It works with Medicare Part D and other prescription drug plans to reduce out-of-pocket expenses.

When you are enrolled in PACE/PACENET and have a Medicare Part D plan that is not partnered with PACE/PACENET, there are a few key points to keep in mind:

  1. Premium Payments: You will need to pay your Medicare Part D premium directly to your insurance provider. PACE/PACENET will not cover this premium 
  2. Prescription Costs: At the pharmacy, you will still benefit from PACE/PACENET's assistance with prescription costs. Your pharmacist will bill your Medicare Part D plan first and then PACE/PACENET for any remaining costs, ensuring you pay the lowest possible amount
  3. Deductibles: The program also helps with deductibles. If you qualify for PACE/PACENET, you may not have to pay the annual deductible for your Part D plan
  4. Formulary Differences: If your Medicare Part D plan does not cover certain medications that PACE/PACENET does, PACENET will either cover those medications or work with your Part D plan to get them covered
  5. No Late Enrollment Penalty: If you qualify for PACE/PACENET, you won't have to pay a late enrollment penalty. This assistance ensures that you won't have to bear the additional cost of the penalty if you enroll in PACE. 

Extra Help, also known as the Low-Income Subsidy (LIS), is a federal program that helps people with limited income and resources pay for Medicare prescription drug plan costs, such as premiums, deductibles, and co-payments.

Here's how it works with a Part D plan:

During the OEP, do not:

  1. Premiums: Extra Help can cover all or part of your Medicare Part D plan's monthly premium. This means you may pay a reduced premium or none at all, depending on your level of Extra Help
  2. Deductibles: The program also helps with deductibles. If you qualify for Extra Help, you may not have to pay the annual deductible for your Part D plan
  3. Co-payments and Coinsurance: Extra Help significantly reduces the cost of prescription drugs. You will pay no more than $4.50 for each generic drug and $11.20 for each brand-name drug in 2024
  4. Coverage Gap: Extra Help eliminates the coverage gap (often referred to as the "donut hole") in Medicare Part D, ensuring continuous coverage for your prescription medications
  5. No Late Enrollment Penalty: If you qualify for Extra Help, you won't have to pay a late enrollment penalty if you join a Medicare drug plan after your initial enrollment period 

While both programs provide financial assistance for prescription drugs, PACE is specific to Pennsylvania residents and has different eligibility criteria compared to the federal Extra Help program.

How to apply for PACE: https://pacecares.primetherapeutics.com/Enrollment.html 

How to apply for Extra Help: https://www.ssa.gov/medicare/part-d-extra-help

AnnuityPro Academy Logo

Get ready to start writing $1MM - $10MM in annuity production with fixed indexed annuity expert, George Sheets! Learn learn how to position yourself as go-to annuity specialist for your current clients, making this innovative process easier than you can imagine. You will:

  • Learn the process to sell annuities easily and earn more for your clients and yourself
  • Gain access to online resources, videos, and trainer notes
  • Host or generate your own live seminars
  • Get step-by-step training and bi-monthly coaching calls

Learn More

Are you trying to access the AnnuityPro Academy resources?

URL Insurance Group agents have exclusive access to AnnuityPro Academy materials. For access to the program and resources please contact Cody Wilbert at 717-216-8063.

Access Materials

URL team members posing with agents.

Please publish modules in offcanvas position.