Managing Changes In Your Retiree Employer Medicare Plan

Published by . Filed under Affordable Care Act, drugs, Medicare Advantage, Medicare Part B, Medicare Part D, retirement, Wisconsin. Total of no comments in the discussion.

Wisconsin health insurance plans can save you money on prescription drugsRetirement comes with its own set of questions and things to look out for, especially with health insurance coverage for individuals who are eligible for Medicare. Retiree insurance coverage offered by a former employer or a retiring spouse’s employer is not a mandatory benefit, and the sponsoring employer may change premiums and benefits or cancel the plan entirely based on their internal needs. If you have group insurance from a retiree plan along with Medicare coverage, Medicare provides primary coverage and your employer-sponsored insurance is secondary. You are, however, responsible for the premiums on your retiree group plans and your Medicare coverage. The cost and coverage varies from company to employee, depending on which package is offered.

Group Retiree Insurance trends for 2017

medicareEmployer-sponsored plans usually include prescription drug coverage. Sometimes that group prescription drug coverage doesn’t meet the minimum requirements of a Medicare Part D plan and therefore is not considered “creditable” drug coverage. If this is not resolved by the group retiree then it will result in late enrollment penalties when an individual Part D plan is purchased.

In today’s market, Medicare Advantage plans provide comprehensive coverage for Medicare eligible beneficiaries and are priced to save significant premium dollars. As an incentive, employers providing qualified prescription drug benefits received a retiree drug subsidy (RDS) amounting to 28 percent of allowed costs. However, changes in the treatment of RDS along with the phase-in of Part D coverage as defined by Affordable Care Act (ACA) guidelines reduced the number of members in employee-sponsored plans.

Other policy changes encouraged employers to partner with Medicare Advantage plans to administer their group retiree plans. Reductions in Medicare payment rates caused dislocations as insurers withdrew from certain markets as the number of members grew.

Evaluating your Group Retiree Coverage

Group retiree benefits vary, and benefits may change as employee sponsors adjust to changes in the health care environment. Benefits may be reduced or altered, and plans may be non-renewed entirely.

According to federal guidelines, participation in the Medicare Part D program is voluntary, but foregoing enrollment when you first become eligible and deciding to enroll later may lead to late enrollment penalties unless you can prove creditable drug coverage in the intervening period. You are responsible for premium payments and cost-sharing portions, including copays, coinsurance and deductibles. However, income-based assistance is offered for Wisconsin residents. You do not have to buy other insurance plans to qualify for a Medicare Part D plan. Likewise, you are not required to carry Part D coverage to keep your Parts A and B plans.

Assessing Alternatives to Retiree Health Coverage

active retireesThe Wisconsin health insurance market is considered one of the most robust in the nation with several alternatives to choose from when it comes to private insurance coverage. Individual coverage is offered to retirees seeking health insurance plans for Medicare Part C, other-wise known as Medicare Advantage coverage. Some of the Medicare Advantage plans may include supplemental health insurance coverage. If you decide to go with a Medicare Advantage Plan, you cannot purchase a Medicare supplement policy. Medicare Advantage plans may include out-of-pocket expenses that are not usually part of Wisconsin’s standardized Medicare supplement policies. Your choice of health care providers may be limited by your plan’s guidelines.

Some employers are turning to the health exchanges for managed retiree health plans. They are also offering Health Reimbursement Accounts to cover out-of-pocket expenses. With this choice, options may be limited to insurance providers that the employer has chosen for channeling these funds. There is also an issue as to whether these exchanges favored by employers offer adequate options to members. These nationwide outfits aren’t representing all options and have no local knowledge of which hospital systems and plans are offered in Wisconsin and other states. They do not offer every Medicare Advantage plan available in Wisconsin and may provide limited or no coverage in certain areas.

Finding Assistance for Health Plan Selection

obamacare wisconsinMedicare agents must be knowledgeable about all the plans available to Wisconsin residents. Contact an agent who represents most or all plans to find the most suitable coverage for your situation. The agent you choose to work with should have in-depth knowledge of Wisconsin’s health insurance market and the relevant guidelines to advise clients properly. Wisconsin offers its own version of Medicare Supplemental Insurance, which includes the Wisconsin Basic Plan that provides coverage for benefits such as mental and home health services, which are not included in standard Medicare plans. There are additionally up to five optional benefit riders that can be added to the basic plan.

Open enrollment ended on December 7 but may be extended to December 31 for coverage effective January 1, 2017 if your plan was non-renewed. If you miss this deadline, you have a special enrollment period year-round whenever you think it’s best to leave your retiree Medicare coverage.

We are Wisconsin insurance experts who will help you obtain a special enrollment period any time during the year due if you meet certain guidelines. Not all Medicare coverage is created equal, but FHK agents study all the factors applicable to you to find the optimum solution to your health coverage needs. Contact our office today to start the process of finding the best insurance for you.

Call us at (414) 228-7555 , or click to review your retiree package at no cost and no obligation.


2017 Medicare Parts A & B Premiums and Deductibles Announced

Published by . Filed under Medicare Part A, Medicare Part B. Total of no comments in the discussion.

piggy bank and stethoscopeDate: 2016-11-10
Title: 2017 Medicare Parts A & B Premiums and Deductibles Announced

2017 Medicare Parts A & B Premiums and Deductibles Announced
Today, the Centers for Medicare & Medicaid Services (CMS) announced the 2017 premiums for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.

Medicare Part B Premiums/Deductibles
Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and other items. Read More…

The Outlook for Affordable Health Insurance in Wisconsin

Published by . Filed under Affordable Care Act, health insurance exchange, insurance company, Wisconsin. Total of no comments in the discussion.

fall-sceneThe Affordable Care Act changed the health care landscape tremen­dously. The gradual rollout of ACA provisions paved the way for an additional 20 million Americans to obtain health care coverage, which would not have been possible without ACA, which is referred to as Obamacare. Based on the latest figures from, nine in 10 Americans now have health coverage. While a large part of the population obtains health coverage through their employers, a significant number depend on the health insurance exchanges to find affordable health insurance in Wisconsin. State governments had the option of establishing their own marketplace or sending their residents to the federal exchanges. Wisconsin opted for the latter. Read More…

How Do Medicare Advantage Plans and Medicaid Work Together?

Published by . Filed under Medicaid, Medicare Advantage. Total of 3 comments in the discussion.

What Is Medicare Advantage?

Health insurance can be confusing for many Wisconsin seniors and their families. Here are a few tips on what you should know before talking to a Milwaukee health insurance agent.

What Is Medicare Advantage?

Medicare Advantage, or Part C plans, aren’t provided by the government. They’re actually offered by private companies that have been approved by Medicare. As a result, the quotes and services you receive may vary.

What does a quote for Part C cover? With this plan, Medicare pays your provider a fixed sum each month. This money goes towards the qualified health care services you use.

Insurers that offer Part C can set their own policy rules and prices. Two quotes with equal dollar amounts may offer distinctly different coverages. Read More…

Open Enrollment 2017: Should I Stay or Should I Change My Plan?

Published by . Filed under Medicare Advantage, open enrollment. Total of no comments in the discussion.
Join us for our 2017 Medicare Meetings

Join us for our 2017 Medicare Meetings

Medicare Advantage plans and prescription drug plans are about to go into their Annual Open Enrollment Period (OEP). There are several reasons to review your Wisconsin 2016 plan with a licensed insurance agent each year.

Many individuals on Medicare in Wisconsin for plan year 2016 are currently enrolled in one of these top three: AARP United Healthcare’s Medicare plan, Humana’s Medicare plan, or Anthem’s Medicare plan. Many individuals on Medicare could be enrolled in a Medicare Supplement as well, along with a stand alone prescription drug plan. During the Medicare Open Enrollment Period, which goes from October 15 through December 7, 2016, you can shop both Medicare advantage plans and prescription drug plans (PDP). Read More…

The Most Affordable Health Insurance Wisconsin Citizens Can Get

Published by . Filed under health insurance exchange, open enrollment, Wisconsin. Total of no comments in the discussion.
affordable health insurance wisconsin

Making your prescriptions more affordable

You might ask, “What is the most affordable health insurance Wisconsin citizens can get?” That’s what FHK is here to answer for you. We understand in these trying times that affordable health insurance that does what you need it to is increasingly difficult to come by. We pride ourselves on being experts in the field of health insurance, and also finding you the best value of your payments.

Affordable Health Insurance Benefits to Consider

Outlining what is most important to you in a health insurance plan is step one. Knowing what you need and want is half the battle of finding affordable health insurance.

Consider the benefits you’re looking for: Read More…

Obamacare Wisconsin

Published by . Filed under Affordable Care Act, Wisconsin. Total of no comments in the discussion.
employees-on-fhk-sign obamacare wisconsin

FHK means experienced, personal service!

Since the introduction of Obamacare Wisconsin citizens have been in search for affordable health insurance plans to accommodate the increased deductibles associated with the transition. Having someone knowledgeable on the topic is just the first step. Trusting that person to recommend the best insurance plan for your needs is the next.

Trustworthy Agents

It’s already known that we provide the most knowledgeable employees in regards to health insurance. With that in mind, we hold them to the highest standards when it comes to the trust they hold between them and their clients. We have created a reputation of trust, and with that comes customer loyalty. We don’t lead people astray from the plan that best suits them and their unique needs. Each person is different, and that holds true with their needs in insurance. With the introduction of Obamacare those needs shifted and became even more complex. Being the forward thinkers that we are, we became experts in the changing system. Read More…

What Would Happen if Premium Tax Credits Went Away in Wisconsin?

Published by . Filed under Affordable Care Act, health insurance exchange, taxes, Wisconsin. Total of no comments in the discussion.

Supreme Court DecisionJust recently, the US Supreme Court voted to uphold Obamacare subsidies. What exactly does this mean?

First, we need to define subsidies. Premium tax subsidies and advanced premium tax credits are both the same thing, and they refer to the income-based discount on Obamacare health insurance. This is the advanced discount to help pay your premium. For example, based on your income, your tax credit could be $150, which reduces your premium by that much every month.

Read More…

Is it too late to get Obamacare?

Published by . Filed under Affordable Care Act, open enrollment. Total of 2 comments in the discussion.

get-affordable-coverage-for-your-familyHas the deadline to sign up for Obamacare passed? No. For those of you that have yet to enroll in a plan, the deadline is fast approaching, February 15th, 2015. The 15th falls on a Sunday this year, and FHK will be open this weekend on both Saturday the 14th and Sunday the 15th during normal business hours, 8:00am until 5:00pm. If this upcoming deadline has you nervous at all, do not worry. The skilled agents at FHK are here to help.

Read More…

Big Changes for Wisconsin Obamacare

Published by . Filed under Affordable Care Act, insurance company, Wisconsin. Total of no comments in the discussion.

change in ACAThere have been major changes to the Obamacare Marketplace this week. Anthem Blue Cross Blue Shield just announced that they are discontinuing major medical health insurance coverage for tens of thousands Wisconsin residents. This change will affect individuals currently on an Anthem Affordable Care Act plan (Obamacare) both on and off exchange.

This news comes as quite a shock considering that just 2 years ago Anthem had a very competitive marketplace plan and was recognized as a strong insurance contender.

Also making news is the announcement that Assurant Health will not be participating in the next open enrollment, set to begin November 1, 2015.

What does this mean for Wisconsin residents?

Read More…