INSURANCE ARTICLES FOR MICHIGAN SENIORS

IMMUNIZATIONS FREE? YES AND NO

010/25/2023

Medicare offers immunizations, such as flu, covid or pneumonia etc., free of charge to its members. Since this is a Medicare benefit all Advantage plans offer this too, at the same price, FREE!

If this is so then how come our office routinely gets our Medicare clients calling or coming to the office to find out why they are being billed. Maybe that bill is a doctor copay and/or a charge for the “use of the room.”

The reason is that providers have a right to charge for a doctor’s visit when getting that shot at the doctor’s office, although some do and some don’t make that charge. Furthermore if the doctor or his/her practice is “owned” by a hospital, as many are these days, the hospital has a right (ahem!) to make a “room” charge up to about $250 as we’ve seen recently.

Sooooo, if you really want an immunization to be “free” of charge make sure you get it at your local pharmacy. At this point they have not latched on to the extra charges bandwagon and just give you the shot and bill Medicare or your Advantage plan for a shot and you have no expense. Keep in mind that pharmacists are “doctors” or PHD of pharmacology and quite able to give injections properly.

Now not all pharmacies do this so you need to check ahead. Most of the national chains do and some small mom and pop’s do also. You need to make sure the pharmacy is IN YOUR ADVANTAGE PLAN’S NETWORK and then you are good to go.

If similar billing questions come up and you don’t know who to turn to give our office a call. Our agents are so capable!!! If they don’t have the answer they know how to get it. CALL US AT (269) 323-7888 AND ASK TO SPEAK TO KRISTA, PAUL OR CHARLEY.  And be sure to get up to date with all those immunizations😊

CONFUSED???

10/12/2023

Lots of confusion out there between traditional Medicare Supplement and Medicare Advantage plans!!!

Every year, as agents for Medicare products, we must study and certify that we totally understand these products and understand which ones are best suited for which people.

If you find yourself wondering which plan is best for your personal needs, give us a call or come in and talk to us and we will go over the pro’s and con’s of each. We can evaluate your personal needs and help you determine which plan type fits you now and for the future. It's for sure that “one size does not fit all” when it comes to Medicare insurance so make it personal to your specific situation and talk to us.

Our trained and certified staff does not “push” you into anything, we EDUCATE and help you make the right decision as to which type of plan would work for you.

Call us at (269) 323-7888 for more information or to schedule an appointment at our office or your home.

Remember, we also have special plans designed for veterans and for those who are on Medicare AND Medicaid.

WHAT HAPPENED TO SUMMER??

09/26/2023

I don’t know about you but it seems like we were just getting ready to honor memorial day and now here we are bumping up to October and fall☹ Well as long as it’s coming let’s get ready for fall and all the Medicare things that fall brings.

For those of you on a Medicare ADVANTAGE PLAN the most important thing to look for at this time of year is the ANOC (annual notice of change) that you should have received in September or maybe you will get it in October.

This may appear to be a very boring toss away mailing you receive from your Medicare Advantage plan, HOWEVER, it is critically important for you to read it and fully understand it. The ANOC will tell you what changes will be occurring in your Advantage plan coverage. It may be a price change, up or down, or a description of a new obligation for you the member to be aware of, or it may discuss new plan benefits and how to use them. The ANOC may also discuss changes to what treatments require prior authorization and how to go about doing that. The notice may also indicate new providers to the plan and their location as well as previous providers who no longer participate.

By knowing what’s coming you can avoid being charged for a procedure that has had a change or even not having the procedure paid for at all. Medicare (CMS) requires that your plan notify you of any and all upcoming changes BUT it is your responsibility to read and understand your notices. You can’t go back to Medicare with an appeal for payment if the information was given to you and you just didn’t read it or understand it.

If, after reading your ANOC, you have questions please feel free to contact the ENDRES INSURANCE AGENCY AT (269) 323-7888 and ask to speak to Krista, Paul or Charley. Any of our agents will be happy to give you the details and what the changes may mean to you. BETTER YET come on into the office (or we can come and see you) and have total review of your benefits to make sure they are still a good fit.

DO YOU QUALIFY?

03/17/2023

As a business owner I do lots of advertising. I try to use my ads to give you, the reader, something of value, to help you navigate the Medicare Insurance world.

Unfortunately, there are lots of advertisers who use their ads to confuse you and rope you into something you may not want.

I can't change the world or how other advertisers operate but I hope this article and others I do help you to bypass tricks, junk and otherwise sneaky advertising so you can avoid scams and unethical practices.

Let's start with the words "DO YOU QUALIFY?" Makes you want to check it out to see if you do qualify for all those goodies doesn't it? Well first you need to know that "to qualify" in Medicare terms means "are you in a recognized enrollment period." It used to mean the time of year referred to as "open enrollment period" which is October 15th and December 7th of each year. Aha!, but now many plans have special designations that allow them to enroll you at any time. (I'll explain that next time)

So, when you see those words on TV or on social media, 9 out of 10 times it's from a vendor who has found a loophole and of course you qualify!!! But when you call you may get a fast talking salesperson who throws so much info at you, you're not sure what anything means. And, without meaning to, you answer a few questions and whamo, you just got changed to a different Medicare plan.

I can't tell you how often we get unhappy confused people in our office who need help getting out of a plan and back to where they were and YES we can get things fixed!! However, save yourself some time and maybe a headache and call the Endres Insurance Agency when you want to find out about ads that sound really good and what they really mean. We can tell you what's going on and give you the information you need without the pain of being switched without your knowledge.

Call us at 269-323-7888 and tell Ashley you want to talk to a Medicare insurance agent for help with questions.  WE WON'T BAMBOOZLE YOU, WE'LL GIVE YOU THE STRAIGHT STUFF!!!

WHOOPS!!!!

12/30/2022

Did you enroll in an Advantage plan via phone, mail or other and now have buyers remorse because it's not the plan you thought it was?? Or, did you intend to make changes to your existing plan but time got away from you and you missed the open enrollment period? Did you hear about a different plan from a friend or relative that sounded a whole heck of a lot better than the one you have but didn't know how to find it or make a change??

GOOD NEWS! There is one more opportunity for you to fix those "whoopses", so call our office (269-323-7888) and ask for Charley, Paul or Krista and find out how we can help you correct your issues and either get you back where you want to be or get you into something you intended to get into. (Note: in most cases we cannot change a prescription drug plan).

The time for this special enrollment period is January 1 through March 31, and our agents know how to fix boo boos.

If you have questions regarding what you did or didn't do about your Medicare insurance coverage and just want to talk to one of our agents give us a call and we will try to answer your questions over the phone if we can. But caution, many boo boos need a face to face to repair.

THE ENDRES INSURANCE AGENCY HAS CERTIFIED CARING AGENTS HERE EVERY DAY TO HELP YOU ENROLL IN A MEDICARE INSURANCE PLAN OR MAKE CHANGES BASED ON YOUR INDIVIDUAL NEEDS. CALL OR COME AND SEE US WE WON'T PRESSURE YOU INTO ANYTHING, JUST DO OUR BEST TO HELP😊

IT'S OVER??
NOPE😊

12/13/2022

Although the Annual Enrollment Period is over you CAN still enroll or change your Medicare insurance coverage!!

CMS bestows stars on all Advantage plans. The stars are given from one star to five. The stars represent CMS's evaluation of the plan, what it offers and how well it operates.

Those plans that get 5 stars get a special reward due to their diligence which allows them to enroll individuals all year long not just at Annual Enrollment time!

The Endres Insurance Agency, which specializes in Medicare insurance, has three carriers who have been rated with 5 stars.

That means if you forgot, were sick, were traveling or for some reason didn't make a change which you intended you can do it now or when convenient to you.

Come and see us or call us and we can explain what these plans offer, how much they cost (if anything) and if you may benefit from enrolling in one. We are here to help you now and in the future with your questions and needs. (269) 323-7888.