1. More Options

Independent agents work with a variety of insurance companies to get you the best coverage at the lowest prices. An independent insurance agent has access to many markets to provide you with the policies you need. This access to choices can mean lower rates, less restrictive policies, and better coverage. Independent insurance agents can often provide ways to cover potential gaps in coverage with the use of policies that work alongside the insurance you already have.

2. Save Money

Since independent insurance agents aren’t tied to one company, they can shop around to offer you the best rates. An independent agent has no brand preference, which means you’ll have the opportunity to compare a variety of prices for the same policy. Often, this comparison can result in significant savings and better coverage for your needs.

3. Unbiased Advice

Insurance agents working with one company have a narrow view of the industry. On the other hand, independent agents work with dozens of companies that provide different types of insurance policies. Additionally, independent insurance agents work closely with customers and can offer advice related to the previous positive or negative experiences of other clients. Since independent insurance agents aren’t advocates for a single company, they can help you find the best prices without any preference for one company over another. This freedom also allows independent insurance agents to find plans better suited to the needs of their customers.

4. They Get to Know You

An independent agent is someone in your local community who can serve your insurance needs throughout your lifetime. This local knowledge provides many advantages. A local agent gets to know you as a person and learns about the changes you
experience over time. They often offer advice and learn about which companies have provided you with satisfactory service in the past. Additionally, local insurance agents have knowledge about specific risks to the area. This knowledge can ensure you avoid any gaps in coverage. A local agent is nearby with the capability to take care of your issues right away when you have questions about your coverage. This personalized service helps you avoid the frustrations of long waiting periods on the phone to talk to an agent in another state who may not even know your name. Working with an independent insurance agent you know can make it easy to keep your insurance updated and seek new policies when you need them.

5. Licensed and Experienced

Independent agents are licensed and have the experience to explain insurance terms in simple understandable language. Since most policyholders aren’t professionals, it can be difficult to understand the coverage you have and what you actually need. Unfortunately, this generally leads to customers who end up leaning toward one extreme or the other. Some choose to purchase only enough insurance to comply with local laws and end up being underinsured. Others end up paying expensive monthly premiums on insurance they’ll never use. Understanding Medicare insurance policies can be difficult, but it doesn’t have to be a hassle. At Healthwise Insurance Agency, our independent agents work closely with customers to form long-term relationships that provide you with the best insurance coverage to fit your needs no matter your lifestyle. Our experienced agents are ready to answer your questions and discuss our available policies. Get personalized service and peace of mind with an independent Medicare insurance agent who really works for you.

Most people don’t recognize life insurance for the versatile financial tool that it is.

If you have a spouse, children, or aging parents who depend on you, life insurance should be part of your overall financial plan. One of your greatest assets is your ability to earn income and maintain a comfortable lifestyle for you and your loved ones. We insure our homes against fires and our cars against collisions—and we should also insure our future quality of life.

Insurance is a Financial Lifeline!

According to Life Insurance Marketing and Research Association (LIMRA), only 59 percent of Americans have life insurance — and about half are underinsured!

Life insurance is a tool to protect against catastrophic losses, pass along wealth to future generations, and offer added financial security.

Here are some answers to commonly asked questions, unique benefits to life insurance.

Why do I need life insurance?

At its core, life insurance helps you create a measure of financial security for anyone you’ll leave behind.

You pay premiums for the defined length of time and the insurance company promises to pay a death benefit to your beneficiary if you die while the policy is active.

Different folks will have different primary purposes for owning a life insurance policy. Here are some common reasons to purchase life insurance:

• Protecting family income.
• Leaving a legacy to children or grandchildren.
• Donating to a charity.
• Paying for funeral and burial expenses.
• Paying off mortgage or other large debt.
• Paying for a child’s college education.
• Planning for a special needs situation.

Term insurance works for most situations. While permanent life insurance covers you for life, it can be more expensive and may not be necessary if you aren’t interested in accumulating cash value.

How much life insurance coverage do I need?

The amount of coverage you’ll need will depend on a few things:

• How much money your family would need to fulfill immediate obligations (e.g., funeral costs and other final expenses)
• Lifestyle expenses (e.g., childcare, housekeeping, landscaping)
• Cash flow
• How many children you have, and their ages
• Years of income that you’ll need to cover
• Annual net income your survivors will need
• Any one-time expenses you wish to fund

What type of life insurance should I buy?

“Term” and “permanent” are the two main categories of life insurance, and they each have their advantages. Most people will do well with a plain vanilla term life insurance policy. Life insurance can play different roles at various stages in life, so you may wish to consider a mix of both types of protection.

Term Insurance

Term insurance is the simplest, most affordable form of life insurance. You’ll pay premiums in exchange for death benefit coverage for the next 10, 20, or 30 years. If you make it past the term period, your policy expires, and you won’t get your premiums back.

Term insurance may be right for you if you’re looking for:

• Affordable coverage during your earning years
• Coverage for specific large expenses (e.g., your mortgage or your children’s education)
• Coverage for immediate obligations (e.g., medical expenses, funeral and estate-settling costs, outstanding debts)

Permanent Insurance

Permanent insurance has two unique features: a “cash value” component, and the death benefit does not expire. You’ll need to pay premiums for the rest of your life, but after a certain amount of time, the cash value will offset some or all of the cost of your premiums.

Permanent insurance may be right for you if you’re looking for:

• Offsetting a decrease in pension income from an early death in retirement
• Legacy planning; transferring wealth across generations
• Estate planning; providing liquidity to an illiquid estate or covering taxes from a sizable estate

Everyone’s life insurance needs are different.

This information is not intended to be a substitute for specific individualized advice.

Please contact me if you have any questions regarding how life insurance can fit into your financial plan.

How long will I need the policy?

This may be the trickiest of the big questions. Of course, we don’t know when we’ll die, and that is a good reason to at least consider a permanent policy. While many people only consider term life insurance to replace lost salary if they die before retirement, coverage after your working years can be critical for your surviving family.

If you’re purchasing a life insurance policy to protect a specific interest—for instance, a business loan or mortgage—also consider the potential duration of that need as you review your options.

How much will my premiums cost?

The biggest factor on how much you’ll pay for life insurance is your age and your health, because the cost depends on your mortality risk to the life insurance company. The younger you are, and the healthier you are, the lower those term life insurance rates are going to be.

That said, life insurance is a very saturated and competitive market. In almost all cases, there will be a life insurance company that can offer a policy to you, even if you’re an older applicant or have health conditions.

Because of that, to get the best rate, your best bet is to shop a full panel of life insurance companies. Every life insurance company is going to approach underwriting, meaning risk evaluation differently.

Work with Dean Henzlik, our top insurance agent, who can help you find the right policy for your needs.

How does permanent life insurance help me build wealth?

A properly designed permanent life insurance policy can give you a wealth of benefits. Our team at Healthwise Insurance Agency can help you find the right policy for your needs.

Learn what Medicare health insurance is, how it works, and the hospital and care services that are typically covered under the 4 parts of Medicare: A, B, C and D.

When I first started my career in the Medicare world, I realized there was a lot of new information to learn for those entering Medicare. I found that breaking it down into bite-sized chunks made it much easier to understand. I started by focusing on all the different parts of Medicare.

Here is a breakdown to help you understand how Medicare works.

What is Medicare?

Simply put, Medicare is a federal health insurance program for:

• People 65 and older
• People under 65 with certain disabilities
• People with end-stage renal disease

• The Medicare program offers basic coverage to help pay for things like doctor visits, hospital stays and surgeries.
• When you’re eligible, you can enroll in Medicare Parts A and B – also known as Original Medicare – through the Social Security Administration. If you are already receiving Social Security or Railroad Retirement Board benefits you’ll automatically be enrolled.
• Original Medicare covers the essentials, but there are a lot of services that aren’t included – important things like prescription drug coverage, annual hearing and eye exams, care needed when traveling outside the United States and much more. Services like these can be covered through private Medicare health plans and Medicare Part D prescription drug plans.
• There are a few different times you can enroll in Medicare and a Medicare plan throughout the year. These are called enrollment periods.

What are the 4 parts of Medicare?

Medicare is broken out into four parts.

1. Medicare Part A – hospital coverage
2. Medicare Part B – medical coverage
3. Medicare Part C – Medicare Advantage
4. Medicare Part D – prescription drug coverage

The parts of Medicare cover different services:

What does Medicare Part A cover?

Part A (hospital coverage) covers things like inpatient hospital stays, home health care and some skilled nursing facility care. Together, Medicare Parts A and B are called Original Medicare.

Is Medicare Part A free?

Typically, most people don’t pay for Part A if they have paid Medicare taxes for a certain amount of time while working. However, if you don’t qualify for premium-free Part A, it can be purchased for a monthly premium. This amount may vary each year and is based on how long you or your spouse worked and paid Medicare taxes.

What does Medicare Part B cover?

• Part B (medical coverage)covers things like doctor visits, outpatient services, X-rays and lab tests, and preventive screenings.

·        Do you need Medicare Part B?

• The short answer is yes, especially if you’ll need the covered services mentioned above. However, if you have health insurance through a current job or are on your spouse’s active plan, you can delay your Medicare Part B enrollment without penalty. Once the spouse with employer coverage stops working – whether it’s you or your partner – you have eight months to sign up for Part B. Also, you need to be enrolled in Medicare Part B if you want to sign up for a Medicare Advantage plan.

What does Medicare Part C cover?

• Part C is also known as Medicare Advantage. Private health insurance companies offer these plans. When you join a Medicare Advantage plan, you still have Medicare. The difference is the plan covers and pays for your services instead of Original Medicare. These plans must provide the same coverage as Original Medicare (so you’re not missing out on anything). They can also offer extra benefits.

·        Why do I need to buy a private health plan?

• Private Medicare health plans – like Medicare Advantage or Medicare Cost plans – cover everything Original Medicare does, and usually include more coverage for services you might need. Plus, they can include extra perks and benefits.

What does Medicare Part D cover?

• Part D covers prescription drugs. Only private insurance plans offer it. It’s usually included in a Medicare Advantage plan or you can get a separate Part D.
• Though Medicare Part B does cover certain vaccines and medications (based on specific health conditions), Part D provides a much wider range of coverage of vaccines and outpatient prescription drugs.

Common services that Medicare does and doesn’t cover

• Here’s general info about what Medicare does or doesn’t cover for common health care needs. Visit gov/coveragefor more detail. Also, check a Medicare health plan’s Summary of Benefits to learn what’s covered.

What isn’t covered by Medicare?

Original Medicare covers the essentials, but there are a lot of services that aren’t covered such as:

• Deductibles, coinsurance and copays for covered services
• Most dental care
• Most outpatient prescription medicines
• Routine eye exams
• Routine hearing exams
• Hearing aids
• Fitness programs
• Services outside the U.S.

Services like these can be covered through a private Medicare plan.

What is the difference between Medicaid and Medicare?

• Medicare and Medicaid (called Medical Assistance in Minnesota) are different programs. Medicaid is not part of Medicare.
• Here’s how Medicaid works for people who are age 65 and older:
• It’s a federal and state program that helps pay for health care for people with limited income and assets. A basic difference is that Medicaid covers some benefits or services that Medicare doesn’t like nursing home care or transportation to medical appointments (depending on your state and your eligibility).
• If you’re age 65 or older and are dual eligible for Medicaid and Medicare,you may be able to get all your services in one plan.
• Visit with one of our agents to explain this dual eligibility program.

Have more Medicare questions?

• We’re here to support you along the way so you can continue to live a better, healthier life. Learn all about your Medicare plan options. Give us a call @ Healthwise Insurance Agency to visit with one of our agents.

See practical tips on when it makes sense to make a switch in Medicare coverage.

Key takeaways

• Medicare Annual Enrollment Period (AEP) begins October 15 and runs through December 7 each year.
• During Annual Enrollment, you can add, drop, or switch certain coverage types, such as Medicare Advantage and Part D prescription drug plans.
• Medicare’s private plans can change every year and potentially impact your coverage and cost options, so it’s a good idea to review your Medicare coverage in advance of every Medicare AEP.

It’s Medicare enrollment time. And from TV ads to robocalls to even advice from your favorite friend, sources all around you seem to be telling you which Medicare plan is right for you. Some are credible; others, not so much.

You especially need to know that your Medicare health insurance has you covered with the right doctors, medical facilities, and prescriptions. If you’re not satisfied with your current plan or your health or financial situation changed, it may be time to take another look at your options. You may be paying a lot for coverage you don’t need, or your health situation may now require the attention of medical specialists who are currently out of your network. Either way, it’s time to investigate other options.

The good news for individuals enrolled in Medicare: If you’re not satisfied with your current Medicare coverage, you can make changes during the Medicare Annual Enrollment Period (AEP), which runs every year from October 15 to December 7.

Generally, there are 5 reasons why you might consider making changes to Medicare coverage:

1. You want a less expensive plan. If you find that Medicare is taking a bigger bite out of your retirement budget, it can pay to shop around to save money.
2. Your health situation has changed, and you need different coverage. If you experience a significant change to your health, you may find that the plan you signed up for cannot support such a change.
3. The cost of your prescription drugs has increased. Sometimes health insurance companies that provide prescription drug coverage raise the price of certain medications. If you happen to take one of those medications, it could end up costing you a lot more money.
4. You’re not satisfied with the quality of medical services in your current network. You may need the ability to see certain specialists or pursue additional avenues of treatment.
5. You want to simplify and consolidate coverage options. This is often the case when people want to shift to an “all-in-one” Medicare Advantage (MA) plan to bring all their coverage together instead of multiple plans handling different types of health care coverage such as Part A, Part B, a Medicare Supplement plan, or a Part D prescription drug plan (PDP).

Tip: Keep in mind, any changes you make take effect on January 1 of the upcoming year.

Did your health insurance company make changes to your existing Medicare coverage?

When it comes to Medicare plans, and health insurance in general, change happens. These modifications are usually made by the health insurance companies that sell Medicare Supplement, PDP, and MA plans. It’s up to you to determine if these changes help or hinder your health care needs.

Every September, health insurance companies that sell Medicare coverage mail out an Annual Notice of Change (ANOC) letter to inform you of changes that are taking place with your current coverage for the upcoming year. These differences can be cost changes to prescription drugs, increased or decreased types of coverage, or expanding or shrinking the network area of doctors and medical facilities. If your coverage becomes more limited or more expensive, that’s the catalyst for you to research all your options and consider making modifications to your Medicare plan.

Why you might want to switch your Medicare coverage

Helpful Medicare enrollment reminders

As you think about possible changes to your coverage for the upcoming year during AEP, keep in mind:

• Medicare Part B covers official COVID-19 testing at no charge, as well as certain medications and equipment used for COVID-19 treatment. Medicare Part A covers 100% of COVID-19 hospitalizations for up to 60 days.
• Medicare Part B and Medicare Advantage plans provide coverage for telehealth services for COVID-19. If you switch from Medicare Advantage to Original Medicare, you’ll need to add a PDP and/or a Medicare Supplement plan to supplement your coverage.
• If you have a pre-existing condition, switching to Medicare Supplement coverage may require medical underwriting (although you can enroll in a Medicare Supplement plan without medical underwriting if it’s the first time you enroll in Medicare when you turn 65).
• Your Medicare decision is made separately from that of your spouse’s. There’s no such thing as Medicare family coverage.
• If you’re adding a PDP for the first time during AEP, and you over age 65, you may be at risk for a PDP penalty added to your monthly premium since you didn’t sign up for a PDP when you were first eligible at age 65.
• Remember, if you already have Medicare coverage and do nothing during AEP, your current coverage will auto-renew January 1 of the upcoming year.

Summary

Although you might be gearing up for a busy holiday season, now is the time to take a fresh look at your Medicare options. Remember, you have from October 15 through December 7 each year to decide what your plan will be for the upcoming year, so don’t delay.

If you have Medicare Advantage, or Original Medicare (with optional Medicare Supplement and/or PDP prescription drug coverage), that isn’t providing the level of coverage you need at a cost that’s affordable, AEP is your chance to course correct.

Yearly Medicare decisions are an important part of your ongoing retirement and financial planning process. Life is full of changes—whether changes to health conditions, adjustments to the coverage, or changes to financial wellbeing—so do your homework, seek help, and look for any gaps between what you need and what your Medicare coverage provides.

What is Part D and how does it work?
What is Part D? It is an optional prescription drug program for people on Medicare. Medicare Part D is simply insurance for your medication needs. You pay a monthly premium to an insurance carrier for your Part D plan. In return, you use the insurance
carrier’s network of pharmacies to purchase your prescription medications. Instead of paying full price, you will pay a copay or percentage of the drug’s cost. The insurance company will pay the rest. Your Part D insurance card will be separate from your Medigap plan. Medicare Part D plans all follow federal guidelines. Each insurance carrier must submit its
plan outline to the Centers for Medicare and Medicaid Services annually for approval.

To improve your understanding of Medicare Part D, let’s look at the basic way that each Part D plan works:

How does Medicare Part D work?
There are 4 stages to a Part D drug plan, as follows:

1. Annual Deductible
In 2022, the allowable Medicare Part D deductible is $480. Plans may charge the full Part D deductible, a partial deductible, or waive the deductible entirely. You will pay the network discounted price for your medications until
your plan tallies that you have satisfied the deductible. After that, you enter initial coverage.

2. Initial Coverage
During this stage of Part D drug coverage, you will pay a copay for your medications based on the drug formulary. Each drug plan will separate its medications into tiers.  Each tier has a copay amount that you will pay. For example, a plan might assign a $7 copay for a Tier 1 generic medication. Maybe a Tier 3 is a preferred brand name for a $40 copay, and so on.  The insurance company tracks the spending by both you and the insurance company until you have together spent a total of $4,430 in 2022.

3. The Coverage Gap
After you’ve reached the initial coverage limit for the year, you enter the coverage gap. During the gap, you will pay only 25% of the retail cost of your medications. (This is so much better than in 2006 when many people had to pay 100% of their drugs in the gap.) Your gap spending will continue until your total out-of-pocket drug costs have reached $7,050 in 2022. Please note that to get into the gap, Medicare tracks the total costs of what you and the insurance company have spent, but to get OUT of the gap, they
are counting only what you have paid in deductibles, copays, and gap spending that year, plus manufacturer discounts. They do not count anything the federal government contributes.

4. Catastrophic Coverage
After you’ve reached the end of the coverage gap, your plan will kick in to pay 95% of the costs of your formulary medications for the rest of the year. This feature in Part D drug plans helps you limit your potential spending if you have expensive medications.

This is the structure in 2022 and will continue into 2023, but with the new Inflation Reduction Act, you will begin to see changes in the Part D structure in 2024.

Medicare Part D Explained
Medicare Tracks Your Part D Spending It’s important to note Medicare itself tracks your True Out of Pocket Costs (TrOOP) for
each year. This can protect you from paying certain costs twice. For example, say you have already satisfied the deductible on one plan. Then you later switch mid-year to a different Medicare Part D plan because you moved out of state. Your new plan will already see that you have paid the deductible for that year. The costs for the coverage gap and catastrophic coverage work the same way.

Part D drug plans also have changes from year to year.  Your plan’s benefits, formulary, pharmacy network, provider network, premium, and/or co-payments/co-insurance may change on January 1st of each year. Medicare gives you an Annual Election Period during which you can change your plan if you desire to do so.

Drug utilization rules that affect your Part D coverage
Medicare allows drug plan carriers to apply certain rules for safety reasons and also for cost containment. The most  common utilization rules that you may run into are:

 Quantity Limits – a restriction on how much medication you can purchase at one time or upon each refill. If your doctor prescribes more than the quantity limit, the insurance company will need him to file an exception form to explain why more is needed.

 Prior Authorization – a requirement that you or your doctor must obtain plan approval before allowing a pharmacy to dispense your medication. The insurance company may ask for proof that the prescription is medically necessary before they allow it. This usually affects medications that are expensive or very potent. The doctor must show why this specific medication is necessary for you and why alternative drugs might be harmful or ineffective.

 Step Therapy – the plan requires you to try less expensive alternative medications that treat the same condition before they will consider covering the prescribed medication. If the alternative medication works, both you and the insurance company save money. If it doesn’t, your doctor will need to help you file a drug exception with your carrier to request coverage for the original medication prescribed. He will need to explain why you need the more expensive medication when less expensive alternatives are available. Often this requires that he shows that you have already tried less costly options that were not effective.

Your overall Medicare prescription costs can be affected by these restrictions. Always check your medications in the plan formulary to see if restrictions apply to any of your important medications.

Restrictions are Part of All Part D Drug Plans
ALL of these three types of restrictions occur throughout the formularies of every Part D drug plan in the market. They are especially common with pain medications, narcotics, and opiates. If you take a significant amount of pain medication, be prepared to deal with this extra paperwork regularly, no matter which drug plan you choose.

Part D plan restrictions are common with pain medications, narcotics and opiates. People often think that changing from one drug plan to another will help. However, nearly all Part D carriers have restrictions on pain meds. You will encounter this no matter which
plan you are on. The best you can do is to pick a carrier with the lowest overall annual anticipated spending. Then file the required exception forms to try to get as much approved as the plan will allow.

There are also some medications that are not covered by Part D. If you take a medication that is not on the formulary, such as a compound medication, you will have to file an exception to try to get that drug approved. Not all exceptions are approved, so be aware that you may pay out of pocket for any medication not covered by your plan or by Part D
as a whole.

Part D drug plans are among the most confusing Medicare topics. All too often, people join a plan without checking to make sure the formulary includes their medications. Sometimes they also miss that one of their medications has step therapy rules applied. Many beneficiaries also miss their initial enrollment window, so be sure not to miss your window if you need drug coverage!

Frequently Asked Questions About Medicare Part D

Do I have to pay for Medicare Part D?
Yes, you will pay a monthly premium to the insurance company whose Part D plan you enrolled in. Everyone pays for Part D unless you qualify for Medicare’s Extra Help Program – Low-Income Subsidy.

How much does it cost for Medicare Part D?
The insurance carriers set the monthly premiums, and they vary widely. In most states, you can find plans starting around $15/month.

Who is eligible for Medicare Part D?
Any Medicare beneficiary enrolled in either Part A and/or B can enroll in Medicare Part D. You must live in the plan’s service area as well.

Should You Skip Part D?
Our agency does not recommend skipping Part D.  Why risk it when most states have plans available for as low as around $15/month? Keep in mind that Part D is insurance not just for your medications today. It also insures you for any new medications that your doctors prescribe in the future. Part D is optional but it is our advice that you do not skip out on the prescription coverage. There are hundreds of medications that cost hundreds or thousands of dollars per year. These would be difficult to afford without coverage.
Don’t forget that Part D is voluntary!
If you wish to enroll, you must contact your agent during a valid election period to initiate the conversation.
Not sure where to start? Talk with our Healthwise Insurance agent today to explore your Medicare Options.

Part A is hospital coverage, and Part B is medical coverage.  Original Medicare is provided by the federal government.  Benefits and coverage are the same across the country.  With Original Medicare, you can also add a stand-alone Part D Prescription drug plan and/or a Medicare supplement insurance plan.  

Medicare Advantage (Part C)

These plans combine your Part A and Part B coverage, and many also include Part D prescription drug coverage and other benefits such as hearing, vision, dental or fitness.  Plans are offered by private insurance companies.  

There are two ways to get drug coverage

You may add a stand-alone Part D prescription drug plan to Original Medicare.  Or you may enroll in a Medicare Advantage plan that includes prescription drug coverage.

Original Medicare (Parts A and B) doesn’t cover everything 

It doesn’t offer coverage for things like prescription drugs, hearing, dental, vision fitness memberships or financial protection.  If you want additional coverage, explore plans provided by private insurance companies with the guidance from your local Health Insurance Expert, Dean Henzlik.

Location impacts coverage choices

Medicare Advantage and Part D prescription drug plans vary in coverage and cost.  Medicare supplement insurance plan basic benefits are the same nationwide, except in MA, MN and WI.  Insurance companies may offer several plans where you live.

Calculate all your Medicare costs

You’re responsible for monthly premiums and out-of-pocket costs like deductibles, copays and coinsurance.  Your costs will vary based on the coverage chosen, the health services used in the year and if you have a financial assistance for Medicare costs.

Protection from high out-of-pocket costs in available

Medicare Advantage plans put a cap on out-of-pocket costs for covered services.  It’s called the “annual out-of-pocket maximum” This doesn’t exist for Original Medicare.  Total out-of-pocket costs and financial protections may vary for in-network vs. out-of-network costs.  Medigap plans help pay some out-of-pocket costs not paid by Original Medicare.  A variety of plans are available that offer different levels of financial protection.  They’re organized by letters, such as “Plan A” or Plan G”. Both Medicare Advantage and Medigap plans are offered by private insurance companies. 

Timing matters when you first enroll in Medicare

Your Initial Enrollment Period (IEP) is your first chance to enroll in Medicare.  It’s 7 months long-includes your birthday month or the 25th month of getting disability benefits, plus the 3 months before and 3 months after. You may qualify to delay Medicare enrollment if you have creditable coverage through your or your spouse’s employer.  Then, you’ll have an 8-month Special Enrollment Period (SEP) that begins either when you lose that coverage or leave your job, whichever occurs first. 

If you enroll after you IEP or SEP, you could face late penalties for Medicare Part A, Part B or Part D.

You may be able to enroll or make changes at other times

Medicare offers a General Enrollment Period every year January 1-March 31 for those who have missed their IEP. Medicare provides Special Enrollment Periods for qualifying life events. 

The Medicare Advantage Open Enrollment Period is January 1-March 31 each year. You may switch Medicare Advantage plans or drop a plan and go back to Original Medicare at this time.

The Medicare Annual Enrollment Period is October 15-December 7 each year. You any change your coverage during this time. 

Our agency can help guide you through these decisions and making changes that are right for you.

1: Know That You’ll Pay More If You Made More
Five words: Income Related Monthly Adjustment Amount (IRMAA). Each year Social
Security looks at your modified adjusted gross income (MAGI) on your tax return from
two years before. That MAGI will determine what you will pay in the current year. If your
income is above a certain threshold, you will pay more than the standard base premium
for Part B. There are several thresholds, so what you will pay depends on your reported
MAGI.
It does make a difference if you file individually or jointly, as the income brackets are
different for both filings. You’ll want to keep in mind that Medicare is individual.
Therefore, you and your spouse must pay the Part B premium and the IRMAA surcharge if
you are subject to IRMAA.
Appealing IRMAA
However, IRMAA is not permanent, and you can appeal it if you qualify for one of the life-
changing events. You would mark on the SSA-44 form which qualifying event fits your
situation and provide the necessary documentation to submit to Social Security.
Once you submit it to Social Security, it can take about 90 days for a representative to
process the appeal. While you are waiting for the response, you will have to pay the
IRMAA surcharge. If the appeal is approved, they generally send a refund check for the
excess amount you paid.

2: Know How You Will Pay for Medicare
The frequency of premium payments is something you will want to know before starting
Medicare. You don’t want to be blindsided by a hefty bill and then scramble to pay it.
Social Security will bill you for your Part B premium when you aren’t receiving Social
Security benefits. That bill is generally a quarterly bill. However, they have sent bills
asking for five months’ worth of premiums. It can be costly, whether it is three months or
five months they are billing you for.
Therefore, you’ll want to prepare for this bill and be ready to pay. You will be able to set up
automatic payments through Medicare Easy Pay, your MyMedicare account, or your
bank. Those payments can be monthly.

3: Know the Late Enrollment Penalties and
Creditable Coverage
If you or your spouse plan on working past 65, you’ll want to know if your coverage is
creditable. If you or your spouse actively work for an employer with 20 or more
employees and that insurance covers you, that coverage is creditable.
However, if there are less than 20 employees, the coverage is not creditable. Additionally,
retiree health plans, VA benefits, Tricare, and Affordable Care Act (ACA) plans are not
creditable for Medicare. When you don’t have creditable coverage, you must enroll in
Medicare Part A and Part B when you are first eligible. If you fail to enroll when you’re
first eligible, you’ll begin to accrue a late enrollment penalty.
The Part B penalty is 10% for every 12 months you go without Part B when you should
have been enrolled. If your coverage is also not creditable for Medicare Part D or you
didn’t have any prescription coverage, you can have a late enrollment penalty for Part D
as well.
Contributing to a Health Savings Account (HSA)
If you contribute to an HSA while enrolled in any part of Medicare, you can be subject to
an IRS penalty. You must stop contributing to your HSA account before your Medicare is
effective. However, when you should stop contributions depends on when you plan to
start your Medicare benefits.

4: Know the Retail Cost for Brand Name Drugs
A big shock to many beneficiaries is the cost of drugs with Medicare. Generally, the cost of
prescriptions under employer coverage is relatively reasonable. However, once you begin
Medicare, your drug plan may have a deductible and coinsurance that you are responsible
for. Most brand-name drugs fall into the higher tiers, which means you’ll pay a percentage
of the cost of the drug. During the year, you could potentially pay 25% of the cost of
expensive medications.
Before you start Medicare, you’ll want to look at the retail price of your drugs. That can
help give you an idea of how much you will pay. Your costs will differ with your Part D
plan, but it lessens the shock by knowing how much the drug truly costs.
5: Know When to Take Social Security Benefits
You can receive Social Security benefits as early as 62 years old. However, when you
begin receiving them before your Full Retirement Age (FRA) your monthly benefit will be
lower than what it could be. If you wait until your FRA, you will receive your maximum
Social Security benefit. Knowing this may help you determine when to take Social Security
benefits.
You may consider speaking with a financial advisor to help you determine when would be
the best time to take those benefits. You’ll also want to consider that once you begin
receiving Social Security benefits and enroll in Part B, your Part B premium will
automatically be deducted from your check each month.

Final Point
Once you begin Medicare, you’ll have to pay the premium and the premiums of other
plans you enroll in. Preparing beforehand for every scenario and situation will be
beneficial, so you aren’t blindsided. You’ll want to consider these tips above before
beginning Medicare and give yourself plenty of time to research Medicare.

Health Benefits of Walking
There are several reasons why walking can be a great form of physical activity. Here
are a few of the specific health benefits of walking.

1. Improve Blood Sugar
A short jaunt around the block after you eat could help keep your blood sugar steady,
especially if you have type 2 diabetes, according to research published in the
journal Diabetologia. When adults with the condition walked for 10 minutes
following every meal, they lowered their blood sugar 12 percent more, on average,
than when they took a single 30-minute stroll each day. "Walking uses large muscles
in your legs and torso-which require a lot of energy," explains Andrew Reynolds,
Ph.D., lead study author and postdoctoral fellow at the University of Otago in New
Zealand. "To get that energy, those muscles remove sugar from circulation and your
blood sugar goes down." He adds that after-meal walks may also help prevent
diabetes in the first place.

2. Help Your Heart

You don't need crazy-hard cardio to strengthen your heart. A review of data from
more than 130,000 women, published in the Journal of the American College of
Cardiology, found that those who walked at least 30 minutes a day significantly
lowered their risk of heart failure. Other research has found that exercisers—and most
of them were walkers-reduced systolic blood pressure (the top number) by an average
of nearly 9 mmHg, an improvement similar to that from medication, according to a
meta-analysis in the British Journal of Sports Medicine. Getting at least 150 minutes
of moderate-intensity exercise, like brisk walking, each week is the benchmark for
heart benefits, according to the American Heart Association.

3. Reduce Dementia Risk
Research has shown that those who walk regularly (think: 3 to 5 times per week for 30
to 40 minutes) had significantly lower risk of dementia than those who didn't partake
in aerobic exercise. This could be because walking helps improve blood flow which
can help improve cognition, but more research is needed to explain walking's
impressive brain-healthy benefits. Walking is an easy way to add more aerobic
exercise to your day, which can help strengthen your body and mind in the long run.

4. Promote Weight Loss
While it can sometimes get overlooked, walking is a great way to get more exercise
and can help you lose weight. Finding ways to up your physical activity is key when
trying to lose weight.

5. Boost Mood
Last but certainly not least, regular exercise like walking can help to boost your
mood—immediately and in the long term. Plus, getting outside for a walk can help
you spend more time in nature, which has proven benefits for your mental health and
can help you reduce stress.

5 Ways to Get More Out of Your
Walks
Spending too much time sitting can lead to numerous health woes. But here's an easy
fix: After an hour of sitting, walk around for two minutes. It could reduce your risk of
early death by 33 percent, according to a study published in the Clinical Journal of the
American Society of Nephrology. Here are some more expert tips on how to get more
out of your walks, solo or with a walking buddy.

1. Go Off-Road
Moving your walks to varied terrain like grass or dirt requires you to use different
muscles that can strengthen your core and improve balance, something you don't get
from walking on asphalt, explains Libby Richards, Ph.D., RN, an associate professor
at the Purdue University School of Nursing. Choosing a route with some gradual hills
can amp up the challenge even more.

2. Add Some Weights
Make your walk more challenging by adding a weighted vest (or wear a backpack) to
increase the load your body is carrying. Add no more than 5% of your body weight to
start and spend only a few minutes walking in it at a time until your body gets used to
it, Richards says.

3. Go Fast and Slow
Dave McGovern, 15-time U.S. Champion race walker and author of The
Complete Guide to Competitive Walking (buy it: $18.95, barnesandnoble.com) likes
doing "turns and straights" on a school track, where you alternate between easy
strolling on the turns and full-tilt walking sprints on the straightaways.

4. Work on Form
Perfecting your gait and posture will inherently help you move faster, McGovern says.
Follow these three tips: Take shorter, faster steps. Land on your heels and roll all the
way through the tips of your toes. And, finally, be sure to bend your arms at 90-degree
angles, vigorously driving them behind your body while keeping the arm swings short
in front of the body.

5. Up Your Walk Time
A slower, longer workout can be just as effective as a faster, shorter one. And hey, it
means more time to chitchat too if you're walking with a friend.

First Things First: Eat a Balanced Diet
As people age, they tend to eat less food and fall into eating patterns that may minimize variety. This is due to many
factors, including loss of appetite, taste changes, teeth/denture issues, side effects from medication, eating on a
budget, and/or dependence on institutional meals. So it is especially important to maximize nutrient-dense foods in
the later years.
Last year, researchers at Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging in Boston
published the new Food Pyramid (MyPyramid) for Older Adults. This eating guide emphasizes the importance of
consuming nutrient-dense foods, sufficient fluid intake, and specific recommendations for the basic food groups. It
advises brightly colored vegetables, deep-colored fruits, lean proteins, and healthy types of fat. A diet that adheres to
these guidelines will help lower the risk of chronic disease yet provide plenty of health-protective nutrients. For more
information, visit http://nutrition.tufts.edu/docs/pdf/releases/071220_ModifiedMyPyramid.pdf.
One noteworthy recommendation is consuming packaged (frozen and canned) fruits and vegetables in addition to
fresh produce. Many people believe that only fresh fruits and vegetables are healthy; on the contrary, packaged
varieties (without added salt or sugar) may be just as healthy as their fresh counterparts and perhaps even more so
since the food is processed soon after harvesting. This early processing protects the food from nutrient losses due to
heat, oxygen, and light.
These choices are easier to prepare and have a longer shelf life, minimizing waste. Canned and frozen fruits and
vegetables are often less expensive than fresh varieties, and they’re readily available when it’s more difficult for
people to get to a grocery store.

Centenarian Study: Lean Is Key
The New England Centenarian Study at the Boston University School of Medicine is the largest, most comprehensive
study of centenarians and their families. One goal of this study is to observe lifestyle factors that study subjects have
in common to try to determine the “secrets” of a long and healthy life. To date, no specific foods have been noted, but
the study has shown that almost all people who reach the age of 100 are lean, particularly men. Obesity may be
considered an actual risk factor for early death, so maintaining a healthy weight is one of the most important dietary
goals.

Lessons From Okinawa
Okinawa, a group of 161 Japanese islands located between the country’s main islands and Taiwan, boasts the
world’s longest living people. They enjoy the lowest rates of heart disease, stroke, and cancer, the three leading
killers in the United States. The average Okinawan woman lives to the age of 86 and the average man to 78
compared with 79 and 72, respectively, in the United States. And they typically die of natural causes rather than
disease. What’s their secret?
A 25-year study on Okinawa, detailed in the book The Okinawa Program: How the World’s Longest-Lived People
Achieve Everlasting Health — and How You Can Too by Bradley J. Willcox, MD; D. Craig Willcox, PhD; and
Makoto Suzuki, MD, reveals myriad lifestyle factors, including diet, that lead to better health and longer life.
Obviously, native Okinawans follow their diets over a lifetime, so an open question is whether an older American can
derive any benefit from adopting an Okinawan diet plan. Studies are underway to determine the diet’s significance
later in life. In the meantime, it certainly wouldn’t hurt to try mimicking the eating style that produces the world’s oldest
and healthiest people.

Okinawans eat an average of seven servings of vegetables and fruits daily, along with seven servings of grains, two
servings of soy products (rich in healthful flavonoids), omega-3 fatty acid-rich fish several times per week, very few
dairy products, and little meat. Specific healing foods and herbs appear to maximize the healing power of the
traditional Okinawan lifestyle, according to the study.

Water: Tried and Still True
Drinking plenty of fluids promotes cleansing, flushes toxins, ensures hydration, and helps maintain healthy skin,
helping people look and feel younger. In addition, adequate water intake reduces constipation and stress on the
kidneys. Seniors whose thirst mechanism has declined may need extra reminders to drink up.

Nuts for a Long Life
Researchers tracked 34,000 Seventh-Day Adventists in California beginning in the 1980s. After 12 years, they linked
the subjects’ consumption of nuts five to six times per week to a longer-than-average life expectancy. Frequent nut
consumers lived 1.5 to 2.5 years longer than nut avoiders, controlling for other factors. This could be due to the
protective fatty acids, excellent mineral content, wealth of phytonutrients, or the impressive overall profile of nuts as a
regular part of a healthful diet. However, many worry about weight gain. While it is true that they are high in fat, nuts
have not been shown to contribute to weight gain when eaten in moderation.

Mediterranean Diet: Worth a Try?
In 2007, the Archives of Internal Medicine reported the results of the National Institutes of Health-AARP Diet and
Health Study, which followed the lifestyle habits of 380,000 people to determine which people died when, how, and
why. This study found that the closer a person’s diet conformed to the traditional Mediterranean eating plan, the lower
the risk of death. In fact, mimicking the traditional diets of Greece and southern Italy cuts the risk of death from all
causes by 20%.
Note that the Mediterranean diet is not only about eating lots of fish and olive oil. A healthful Mediterranean diet
focuses on vegetables, legumes (dried beans and peas), fruits, nuts (especially walnuts), whole grains, fish, and a
high monounsaturated-to-saturated fat ratio and deemphasizes alcohol and meat. Swapping burgers for fish and
loading up on fruits and veggies really can make a difference.

Seeing Green
Age-related macular degeneration affects the macula, the center of the retina’s inner lining. This progressive disease
gradually compromises sharp vision, making it difficult to see details and recognize faces. While there is no cure,
research has demonstrated ways to help prevent, as well as slow, the progression of the disease.
Many studies have shown a protective effect of lutein, a phytochemical found mainly in leafy green vegetables and in
some other foods. Think of these foods as sunblock for your eyes. Eat leafy green vegetables, especially dark ones
such as kale, collards, and chard, on a regular basis for their lutein, as well as their wealth of other disease-fighting
properties.

Spice It Up
Many recent studies have focused on “herbs and spices’ health-protective properties. For example, sage, oregano,
turmeric, cloves, and cinnamon have all been shown to lower fasting blood sugar levels in people with diabetes.
Better blood sugar control means prolonged health and lower risk of damage from diabetes-related maladies.

Dried Fruit: Nature’s Candy
Dried fruits such as figs and dates are chock-full of fiber and potassium, which help regulate blood pressure. They
pack in many times more antioxidants than other fruits. A 2004 Harvard study showed that eating three or more
servings of high-antioxidant fruit per day lowered the risk of age-related maculopathy by 36% in people aged 50 and
older. To check the antioxidant content of common foods, consult the Oxygen Radical Absorbance Capacity
database at http://ars.usda.gov/services/docs.htm?docid=15866.

Keeping the Brain Sharp With Açai and Other Berries
Age-related diseases of the brain such as Alzheimer’s and Parkinson’s disease have no cure, but research suggests
that diets rich in antioxidants and anti-inflammatory polyphenolic compounds may lower the risk of developing age-
related neurodegenerative diseases. Such compounds, notably anthocyanins, are abundant in berries and may lower
oxidative stress and inflammation, thereby promoting brain health. Açai berries (available dried, frozen, as juice, and
as a powder) have the highest level of antioxidants but, of course, they’re not a miracle cure (nor are they very tasty
solo). It’s not about choosing from only the top of the antioxidant list; it’s about choosing an abundance of antioxidant-

rich foods daily. Strawberries, blueberries, blackberries, raspberries, and others are good choices, along with other
high-antioxidant foods.

Ginger for Healthy Joints
Older adults at risk of or suffering from arthritis may want to try ginger to extend pain-free years. Ginger is known to
exhibit anti-inflammatory effects that work directly on the joints to help relieve arthritis. One Danish study shows that
among patients taking ginger, more than 75% experienced relief in pain and swelling from arthritis.

Go Fish?
Researchers from the Harvard School of Public Health recently weighed the risks and benefits of consuming fish. The
researchers concluded that the disease risk-reduction benefits of consuming one to two servings of fish per week
outweighed the potential harm from mercury exposure, possibly helping to extend healthy years.
Myriad studies have focused on the beneficial effects of the omega-3 fatty acids found in fish. These fats help reduce
inflammation and protect the integrity of cell membranes from free radical damage. Omega-3 fatty acids may help
protect people from age-related neurodegenerative disease, cognitive decline, arthritis, and cardiovascular disease.
For those who dislike fish or are vegetarians, other excellent sources of omega-3 fats include flaxseed and flax oil,
canola oil, walnuts, soybeans, hemp seeds, and large amounts of leafy green vegetables.

Green Tea Covers the Bases
Scientific literature includes studies on the benefits of green tea. Green tea drinkers reap the potential benefits of the
prevention of and/or treatment for cancer, heart disease, skin conditions, atherosclerosis, stress, viruses, arthritis,
and type 2 diabetes. Theoretically, these bioactive chemicals protect the body from oxidative damage and help
maintain the integrity of the cells’ DNA and membrane structure. No wonder so many healthy older adults worldwide
drink green tea.

The Big Picture
We all want long, healthy, disease-free lives. And we all know that healthy eating, stress management, exercise, and
other positive lifestyle habits help us move closer to this goal. Take advantage of myriad healthful and interesting
foods known to improve health and help incorporate the science of disease prevention and longevity into your eating
habits.