Corona Virus and Medicare

Covid19, otherwise known as Corona Virus, has hit, and unless you are over 200 years old (and still have a great memory…) you’ve never seen anything affect the world quite like this. It’s affecting every corner of the world, and unfortunately, folks over the age of 65 are at the most risk.

That said, as most folks are doing, the best thing you (or any of us) can do, is to stay put.  Stay at home. As much as possible.

The term “telehealth or telemedicine” are terms that a lot of people are inquiring about. Basically, it’s the ability to utilize current technology to video conference with a health provider with a computer, tablet or smartphone. If you have a Medicare Advantage plan, you probably already have this, or some form of this, built into your plan, and it’s probably free. Some plans offer video consultations with a doctor, some have 800 number hotlines to speak with a registered nurse, and some plans offer both! In most plans, these options require no co-pay. For my clients, you can always call me to inquire about these features, but even easier, (and this is true for anyone, client or not) you can call the customer care number on the back of your card for specific details. It’s a GREAT feature! Use it!

Most of all, be safe. Be kind. Help someone if you can. And call me if you need help!


-Will Isaac


Be Very Careful During the Open Enrollment Period!

Just a quick word of warning for all my friends and clients on Medicare. We are currently in a period that Medicare refers to as the Open Enrollment Period. This period started January 1st and ends March 31st. It allows anyone with a Medicare Advantage plan to make a one time change, either to a different Medicare Advantage plan, or go back to original medicare. The reason I bring all this up is that I’ve gotten questions and comments about the commercials that Joe Namath is running about how great this company is that got him his Medicare benefits and how everything is free!! His commercials are not the only ones either.

PLEASE BE WARY! Before you make a change to your coverage, do yourself a favor and consult with an actual insurance professional, preferably and independent broker who ISN’T tied to any one insurance company. These companies WILL put you in a different plan, but likely not the plan that fits you best. You may quickly find that some of your prescriptions may not be covered, and some or all of your doctors may not take the plan they’ve put you on. At that point, it’s too late to do anything and you’d be stuck with your new plan until the next Annual Enrollment period.

Again, it doesn’t have to be me, but before you call an 800 number and make a potentially disastrous plan change, contact an independent insurance broker! Find someone who will look out for YOUR best interests, not the company THEY work for!

Summary of Recent and Proposed Changes to Medicare Prescription Drug Coverage and Reimbursement

The following article is from the Kaiser Family Foundation page. You can see the original article HERE.


A look at recent and proposed changes to #Medicare prescription drug coverage & reimbursement in the #TrumpBudget and the Bipartisan Budget Act .

Summary of Changes in the BBA of 2018

  • Part D coverage gap and manufacturer discount: Closes the Part D coverage gap in 2019 instead of 2020 by accelerating a reduction in beneficiary coinsurance from 30 percent to 25 percent in 2019; also increases the discount provided by manufacturers of brand-name drugs in the coverage gap from 50 percent to 70 percent, beginning in 2019. In 2019 and later years, Part D plans will cover the remaining 5 percent of costs in the coverage gap, which is a reduction in their share of costs (down from 25 percent). The manufacturer discount will continue to count towards a beneficiary’s “true out-of-pocket spending” (TrOOP), the spending amount that triggers the start of catastrophic coverage. Estimated budget impact: not estimated separately by CBO; included in biosimilars provision below
  • Biosimilars: Beginning in 2019, biosimilars will be treated the same as other brand-name drugs in the Part D coverage gap, with manufacturer discounts of 70 percent; previously biosimilars were not included in the coverage gap discount program. Estimated budget impact: -$10.05 billion
  • Income-related Medicare premiums: Increases Medicare Part B and Part D premiums for beneficiaries with incomes of $500,000 (for individuals) and $750,000 (for married couples) or more, to 85 percent of program costs, up from 80 percent, beginning in 2019. Estimated budget impact: -$1.63 billion

Summary of Proposed Changes in the President’s FY2019 Budget

Part D

  • Share rebates with Part D enrollees: Would require Part D plans to pass on at least one-third of total rebates and price concessions to enrollees at the point of sale. The Administration solicited comments on potential policy approaches related to this idea in a November 2017 proposed rule for the Medicare Advantage and Part D programs. Estimated budget impact: +$42.16 billion
  • Add an out-of-pocket limit to Part D and change reinsurance: Would establish an out-of-pocket limit in the Part D benefit by phasing down beneficiary coinsurance in the catastrophic coverage phase of the benefit from the current 5 percent level to 0 percent (no cost sharing) over four years, beginning in 2019.2 Also would increase plans’ share of costs in the catastrophic coverage phase of the benefit from 15 percent to 80 percent, and decrease Medicare’s reinsurance from 80 percent to 20 percent. The Medicare Payment Advisory Commission (MedPAC) recommended similar changes to Part D reinsurance in 2016. Estimated budget impact: +$7.36 billion
  • Change TrOOP calculation: Would exclude manufacturer discounts from the calculation of beneficiaries’ “true out-of-pocket spending.” MedPAC also recommended this change, in combination with the proposed changes to catastrophic coverage above. Estimated budget impact: -$47.02 billion
  • Change Part D formulary standards: Would loosen Part D plan formulary standards by requiring plans to cover a minimum of one drug per drug category or class, down from the current two-drug requirement. Would expand plans’ ability to use utilization management tools for specialty drugs and drugs in the six protected classes (anticonvulsants, antidepressants, antineoplastics, antipsychotics, antiretrovirals, and immunosuppressants for the treatment of transplant rejection). Estimated budget impact: -$5.52 billion
  • Eliminate cost sharing for generics for low-income enrollees: Would eliminate cost sharing on generic drugs for Part D enrollees receiving the low-income subsidy (LIS), including biosimilars and preferred multisource drugs, beginning in 2019. MedPAC recommended a similar change in 2016. Estimated budget impact: -$0.21 billion
  • Retroactive Part D coverage for low-income enrollees: Would permanently authorize CMS to contract with a single Part D plan to provide Part D coverage to low-income beneficiaries while their LIS eligibility is processed, beginning in 2020; this is currently a demonstration program scheduled to run through 2019. Estimated budget impact: -$0.30 billion

Part B Drug Reimbursement

  • Average sales price data reporting: Would require manufacturers of Part B drugs to report average sales price (ASP) data and would authorize the Secretary of Health and Human Services (HHS) to apply civil monetary penalties if manufacturers do not meet reporting requirements, beginning in 2019. Estimated budget impact: no budget impact
  • Establish a limit on Part B reimbursement growth rate: Would establish an inflation limit for reimbursement of Part B drugs paid based on ASP, with the growth in the ASP portion of Medicare’s reimbursement to physicians for these drugs (currently ASP plus 6 percent) limited to growth in the Consumer Price Index for all Urban Consumers (CPI-U), beginning in 2019. Currently there is no limit on updates to the ASP plus 6 percent reimbursement if the ASP increases. Under the budget proposal, reimbursement to physicians for Part B drugs paid based on ASP would be the lesser of actual ASP plus 6 percent or the inflation-adjusted ASP plus 6 percent. Estimated budget impact: not available
  • Coverage of certain Part B drugs under Part D: Would authorize the HHS Secretary to consolidate coverage of certain drugs under Part D that are currently covered under Part B, beginning in 2019, subject to a determination that there are savings to be gained from the consolidation (shifting from the ASP plus 6 percent reimbursement under Part B to negotiated pricing under Part D). Estimated budget impact: not available
  • Reduce wholesale-acquisition-cost based reimbursement rate: Would reduce wholesale acquisition cost (WAC) based payments for new Part B drugs where ASP data are not available, from 106 percent to 103 percent of WAC, beginning in 2019. Estimated budget impact: not available
  • Redistribution of savings from 340B payment reductions: Would make changes to the 340B discount program, building on recent changes to Medicare’s payment rate for certain Medicare Part B drugs purchased by hospitals through the 340B program, which is decreasing from ASP plus 6 percent to ASP minus 22.5 percent, beginning in 2018. Under the budget proposal, savings generated by this reimbursement change for 340B drugs would be redistributed to certain hospitals that provide a minimum level of charity care or would be returned to the Medicare trust funds, beginning in 2019. Hospitals would be eligible for an allocation of the savings from the 340B drug payment reduction if the value of uncompensated care they provide equals at least one percent of their total patient care costs. Estimated budget impact: not available
  1. The Administration’s budget did not specify whether the budget estimates took into account changes in the BBA of 2018 that would affect the costs or savings associated with proposals in the FY2019 budget.

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  2. In 2015, 1 million Part D enrollees who did not receive low-income subsidies had spending in the catastrophic coverage phase of the Part D benefit. While those who reach the catastrophic coverage phase of the benefit would see savings from the elimination of coinsurance above the catastrophic threshold, the Administration’s proposed changes to the TrOOP calculation (described above) would likely mean that fewer enrollees would reach the catastrophic coverage phase in future years since they would be required to spend more out of pocket to pass through the coverage gap and enter the catastrophic phase of the benefit.

10 advantages of term life insurance

I can’t take credit for this article. This was originally posted at You can see the original article HERE.

Term life insurance is among the devices that people should consider when they want to provide an immediate estate for loved onces after their death.

Although term insurance is not always the most effective type of life insurance for all of a client’s death benefit needs, it can be useful in many circumstances.

Since term insurance is not just one product, but rather many variations on a general theme, different types of term insurance are indicated for different client needs.

Keep in mind, term insurance, more than any other type of insurance, is pure death protection with little or no ancillary or lifetime benefits. Therefore, the two overriding considerations in the use of term insurance, regardless of the specific application, are:

    1. Will death protection alone meet the need?
    2. Will the coverage last as long as the need?

In short, with term life insurance — as with any other decision about appropriate coverage — the product must match the problem.

Although some agents and advisors believe that whole life insurance is always a superior product, term life insurance does have an important roll to play in a client’s financial plans. Keep reading 10 reasons why a client may want to consider a term life insurance policy, from the 6th Edition of “The Tools & Techniques of Life Insurance Planning” (2015, The National Underwriter Company).


10 advantages of term life insurance

Term Life Insurance Advantage No. 1

Term insurance allows a person to acquire the greatest death benefit for the lowest premium outlay when the policy is first issued. However, this does not mean that term insurance is necessarily the least expensive form of insurance over the full duration of needed coverage. Because term premiums increase at each renewal, at the later ages the premium cost will far exceed the level premium that would have been charged for an ordinary whole life policy issued at the same age as the original term policy.


10 advantages of term life insurance

Term Life Insurance Advantage No. 2

Term insurance is the best alternative for temporary life insurance needs. Usually term insurance is the best alternative if protection is needed for less than ten years. Conversely, some form of cash value life insurance will generally be the best alternative if protection must continue for fifteen or more years. If the duration of the needed protection is between ten and fifteen years, the best alternative depends upon the facts and circumstances of the case. As a general rule of thumb, term insurance will tend to be better than cash value insurance at issue ages below age forty-five, and worse at older issue ages if the length of the need for protection is between ten and fifteen years.


10 advantages of term life insurance

Term Life Insurance Advantage No. 3

Younger persons may acquire substantial face amounts of coverage at relatively low immediate cost, perhaps more than their immediate needs, and thereby guarantee that they will have the necessary level of coverage when their needs and family obligations later increase, even if they are then uninsurable.


10 advantages of term life insurance

Term Life Insurance Advantage No. 4

The conversion feature of renewable and convertible term allows policyholders to enjoy higher death protection than they could otherwise afford and later allows them to lock-in their premiums and build cash values when their ability to pay premiums increases.

10 advantages of term life insurance

Term Life Insurance Advantage No. 5

Various types of term insurance — level, decreasing, and increasing — can be combined as riders with other types of permanent insurance to create a package that meets a person’s special death protection, savings, and affordability needs.

10 advantages of term life insurance

Term Life Insurance Advantage No. 6

Life insurance proceeds are not part of the probate estate, unless the estate is named as the beneficiary of the policy. Therefore, the proceeds can be paid to the beneficiary without any delay caused by administration of the estate.


10 advantages of term life insurance

Term Life Insurance Advantage No. 7

There is no public record of the death benefit amount or to whom the death benefit is payable (if paid to someone other than the deceased’s estate).

10 advantages of term life insurance

Term Life Insurance Advantage No. 8

The death benefit proceeds are generally not subject to federal income taxes.


10 advantages of term life insurance

Term Life Insurance Advantage No. 9

The death benefit proceeds are often exempt from state inheritance taxes.


10 advantages of term life insurance

Term Life Insurance Advantage No. 10

Life insurance policies can be used as collateral or security for personal loans. Although lenders generally prefer permanent types of policies because of the cash values, a term policy is often sufficient if the borrower is a good credit risk and the loan is very likely to be repaid unless he or she dies.

Financial Repercussions of Not Having Life Insurance

I know most people don’t like to think about death however it is a part of life that none of us can avoid.

With that said there are many financial repercussions of not getting life insurance. One of the biggest issues is that in the event of pre-mature passing your family will be left with a potentially heavy financial burden – everything from funeral & burial expenses to mortgage payments and the upbringing of children.

o Average cost for a funeral & burial: $6500 to $10,000 according to National Funeral Directors Association

o Average cost to raise one child to the age of 18: approx. $250,000 according to the US Dept. of Agriculture

In today’s economy the loss of a person’s income can be especially devastating. Having a life insurance policy in place in case of an untimely death can mean the difference between surviving members of your family living comfortably vs. potentially losing everything.

Each family’s situation is different however there are some important factors to consider when looking at getting a life insurance policy. Below are some of the things to think about:

o Dependents – how many and how many more years do they need to be taken care of?

o Mortgage – how much is left on your mortgage if you were to pass away tomorrow?

o Employment – does one parent work and the other not then there is going to be a huge financial burden left to the parent that doesn’t work in the event the breadwinner passes away; if it is a 2 income household there will now be a loss of that second income to consider

o Debts – any other debts that need to be taken care of besides your mortgage such as credit cards, medical expenses and car payments

Term life insurance is a very affordable type of life insurance that can be worked to fit your family’s financial needs. Protect your family now by getting and comparing term life quotes online. It’s fast, easy and convenient and nothing compares to the peace of mind you’ll have once obtaining a policy.

If you don’t already have a policy what are you waiting for, now is the time to get one. If you do have one you might want to look it over and see if it matches with your current needs.

Another Health Insurer Announces Exits From Obamacare Markets

Here’s a link to the original article:


by Caitlin Bronson | May 06, 2016

Weeks after UnitedHealthcare announced it would no longer be offering Obamacare policies in the majority of state markets, another of the country’s leading insurers has taken the first steps in following suit.

Officials with Humana Inc. said Thursday that the insurer plans to exit markets in at least two states to stem financial losses. As of 2017, the insurer won’t sell Affordable Care Act plans in Alabama and Virginia.

Elsewhere, Humana will pull off-exchange, ACA-compliant plans from Tennessee and withdraw some of its offerings in Colorado.

The announcement comes one day after Humana said it would evaluate each state and decide whether to continue selling plans through the ACA or directly to consumers. The move is expected to save the company money, following another disappointing financial performance – first-quarter earnings for Humana fell 46%, dogged by both the exchange plans and its direct-to-customer Medicare Advantage plans.

“Over the next few weeks, we will continue working with state and federal regulatory agencies to finalize these decisions prior to the open-enrollment period this fall,” said Humana spokesperson Tom Noland.

The insurer currently sells plans in 15 states, and has about 554,300 individual members from the exchange.

A potentially larger exit would not affect as many markets as UnitedHealth’s withdrawal will, but it could further limit options for consumers in more rural parts of the country – particularly in the South, where it overlaps with UnitedHealth in Alabama, Georgia and Tennessee.

The withdrawal is not a surprise for some industry observers; thanks to new ACA enrollees who have medical costs 22% higher than the average American, insurers lost money in the individual markets of 41 states during 2014. With those figures, even more companies may begin pulling out.

Anthem, another leading insurer, has already said it continues to have “serious reservations” about the state of the market and has reserved the right to pull out if necessary in the future.

That signals uncertainty ahead, some say.

“If you thought it was going to get fixed in a year or two, you’d stick around,” said Robert Laszewski, who runs Health Policy and Strategy Associates. “The implications of that are that the program just isn’t working in its current form.”

But not all of the country’s “Big 5” health insurance companies feel this way. Last week, Anthem Chief Executive Officer Joseph Swedish reaffirmed the company’s commitment to the ACA markets, saying Anthem had more customers on the exchanges than it had anticipated this year.

More than 184,000 new members signed up for coverage under Anthem through the first quarter, and executives of the company say Anthem will at the very least break even, and possibly hit small profit margins of 3% to 5%.

Swedish said the company’s pending acquisition of Cigna Corp. will put it in an even better position to remain competitive and perhaps even expand into more markets.

What’s the Difference Between Whole Life and Term Life Insurance?

Choosing Life Insurance: The Facts You’re Missing

Life insurance can be very confusing. What is term life insurance? What is whole life insurance? How can you get the information you need and make the right decision about life insurance for you and your family or other beneficiaries? We’ll provide an overview of these two popular types of life insurance so you can get an idea of what might be a good fit for you.

Differences Between Whole Life and Term Life

Deciding whether to purchase whole life or term life insurance is a personal decision that should be based on the financial needs of your beneficiaries as well as your financial goals. Life insurance can be a very flexible and powerful financial vehicle that can meet multiple financial objectives, from providing financial security to building financial assets and leaving a legacy.

Here are some of the main features of term and whole life insurance.

  • Features of term life insurance
    • Provides death benefits only
    • Pays benefits only if you die while the term of the policy is in effect
    • Easiest and most affordable life insurance to buy
    • Purchased for a specific time period, such as 5, 10, 15, or 30 years, known as a “term”
    • Becomes more expensive as you age, especially after age 50
    • The term must be renewed if you want coverage to be extended beyond the term length
    • Can be used as temporary additional coverage with a permanent life insurance policy
    • Can be converted to whole life insurance
  • Features of whole life insurance:
    • Covers you for life
    • Provides death benefits as well as a cash value accumulation that builds during the life of the policy
    • You typically must qualify with a health examination
    • Can be purchased without a medical exam, but at a higher cost
    • Takes 12 to 15 years to build up a decent cash value
    • Can be a good choice for estate planning
    • Cash value is based on how much the return on investment is worth
    • A portion of the cash value can be withdrawn or borrowed during the life of the policy
    • Initially has more expensive premiums than term life insurance, but can potentially save you money over the life of the policy if in force for a considerable number of years

Whole Life or Term Life Insurance Variables and Considerations

When choosing between whole life or term life insurance, there are a number of variables to take into account. A knowledgeable life insurance agent can help you evaluate each of the following aspects of your circumstances and determine whether term life or whole life is a better option for you. The factors to consider include:

  • Your current age
  • Current state of your health
  • Financial needs of your family
  • Plans for funeral and death expenses
  • The age of your children
  • Long term health expenses in the event of a serious illness
  • Your mortgage and current debts
  • When you plan to retire and the retirement plan you have in place
  • Future needs of your family, such as your children’s college tuition
  • Your need for an additional retirement savings plan
  • Your plans and concerns regarding setting up an estate and ramifications for estate taxes
  • Your intention to set up a trust as part of your will
  • Whether you want to donate life insurance proceeds to a charity
  • Your feelings on potentially paying into a term policy and never receiving any of that value back

Hypothetically, if you are 35 years old, have young children, and are the primary income earner in your household, you might want to consider buying a term life policy that would fully cover your family’s financial obligations.

Adding up your living expenses, your home mortgage, pay-off of all debts, and your children’s education can help you understand the face value of a policy your family will need if you die prematurely. The length of the term would likely depend on the age of your children and when you foresee them completing college.

Alternatively, you could purchase a whole life policy that will not only pay that policy face value if you should die before your children are through college, but would accrue a cash value that would provide additional benefits to your family or a growing fund of emergency money. You could also consider converting portions of your term life policy over to whole life insurance over time to build a cash portfolio for your retirement as you age.

If you are just starting to consider life insurance at the age of 60, your children are most likely grown up and on their own, and your needs are very different. You might want a small termlife insurance policy that could cover your final expenses, or you might be looking for a term life or whole life policy that could provide for your spouse’s needs if he or she lives on after your passing.

There are many creative and flexible options with life insurance that can meet your unique needs. Only a qualified life insurance professional can help you compare term life vs. whole life and determine which would be the best strategy for you.

How to Compare Term Life and Whole Life Side by Side

Now that you have a better picture of the difference between term and whole life policies, you probably want to compare term life versus whole life insurance costs. To do so, you will need to directly compare the short and long term costs of a whole life policy and a term policy, based on factors like your age, the face value of the policy you want to buy, and whether or not you are a smoker.

You may find that your out-of-pocket costs for whole life insurance seem daunting compared to term life insurance. This is because the dollars you pay into term life insurance premiums are only there to provide a death benefit to your beneficiaries if you die during a specified term, while money you invest in whole life insurance premiums builds cash value that you can use later in life or that will add to the death benefit payout. The percentage of your costs that go into your cash accrual account increases with passing years, as many of the administrative costs associated with setting up the policy and associated investments occurs early in the life of the policy.

Should You Convert Your Term Life to Whole Life Insurance?

Most term life insurance policies allow you to convert your term policy into a permanent life insurance policy such as whole life insurance. Is this the right thing to do? Some of the reasons it may be a good idea to convert your term policy to a whole policy include:

  • Your term life policy is about to expire and you are in your 50s or 60s.
  • You want to extend your life insurance coverage, but term insurance may no longer be available or has become very expensive due to your current age.
  • You are setting up an estate, or you are concerned about estate taxes.
  • You are setting up a trust in your will.
  • You need a non-taxable investment option.

Converting term life to whole life insurance can be an excellent way to continue your life insurance policy and also build cash value that you can borrow from. There are many different ways to structure this type of policy, depending on your needs and goals, so be sure to work with a life insurance professional who can answer all of your questions and help you make the best choices.

Should You Buy Both Whole Life and Term Life?

You can own both whole life and term life policies at the same time. People who are looking at this option typically already have a whole life policy. However, they may find that they want additional short-term insurance coverage such as for 10 years. In this instance, buying a term policy for the amount of life insurance you need for that extra protection can be a good solution.

Or, you may already own a term policy and find that you want to invest some additional money into a long-term investment for retirement purposes or because of estate issues. In this instance, buying a whole life policy which has a cash value accumulation feature may be the way to go.

Now that you know the differences between term life insurance and whole life insurance, you can make an informed choice to find the best life insurance solution for you and your family.

The 4 Basic Parts of Medicare….. an Overview…

First, a link to the best overall site on the internet relating to Medicare, . Anything and everything you might need to know, can be found there, though as good as it is, parts can be confusing. Therefore, I’ll use this site to break down  certain aspects of Medicare, into “bite-sized” chunks. First, the basics. There are 4 parts to medicare. Following is an exert from the aforementioned web site:

What Is Medicare?

Medicare is health insurance for the following:

  • People 65 or older
  • People under 65 with certain disabilities
  • People of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant)

The Different Parts of Medicare

The different parts of Medicare help cover specific services:

Medicare Part A (Hospital Insurance)
  • Helps cover inpatient care in hospitals
  • Helps cover skilled nursing facility, hospice, and home health care

Medicare Part B (Medical Insurance)

  • Helps cover doctors’ services, hospital outpatient care, and home health care
  • Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse

Medicare Part D (Medicare Prescription Drug Coverage)

  • A prescription drug option run by Medicare-approved private insurance companies
  • Helps cover the cost of prescription drugs
  • May help lower your prescription drug costs and help protect against higher costs in the future

Medicare Advantage Plans (like an HMO or PPO) are health plans run by Medicare‑approved private insurance companies. Medicare Advantage Plans (also called “Part C”) include Part A, Part B, and usually other coverage like Medicare prescription drug coverage (Part D), sometimes for an extra cost.

Hello world!

Welcome to Medicare 101! My name is Will Isaac, and I am an independent insurance agent based in Lawrenceburg, Kentucky.

The purpose of this site is to inform, educate and possibly even assist senior citizens and their families get answers to their questions regarding Medicare and all other associated healthcare issues. Occationally, I’ll try to post other information pertaining to senior’s needs as well. If you have questions or suggestions, please send me an email or post a comment.