Is Silver Sneakers A Government Program
SilverSneakers is considered a basic fitness service and Original Medicare, Part A and Part B, does not cover this benefit. However, Medicare Advantage plans, also known as Medicare Part C, may provide this benefit. To find a Medicare Advantage plan with SilverSneakers in your area, enter your zip code on this page.
How Do I Know If Im Enrolled In Extra Help
Youll receive notice of your Extra Help status from the SSA. Notices are different colors depending on your status:
- Purple notices mean youre automatically qualified.
- Yellow or green notices mean youre automatically enrolled.
- Gray notices mean youre no longer automatically qualified.
- Orange notices mean the amount of Extra Help youre getting is changing.
Its important to keep an eye on your mail and keep track of the notices you get from Social Security. Reading all communication ensures you wont be surprised by any costs and will have time to prepare for any changes.
Commission For Selling Medicare Advantage Plans
DD: A lot of agents are looking at this like weve talked about it from a final expense standpoint.
Theyre used to getting pretty high first year commissions selling final expense or maybe selling mortgage protection.
These types of life insurance generally have a higher first-year commission.
What about Medicare Advantage?
Do you see the Medicare Advantage world as a first-year commission driven business or more of a renewal driven business model?
LM: I love the commission structure with Medicare. Renewals really are the reason why youre selling this product.
If you end up writing somebody who is aging into Medicare, somebody 65, they just got their Medicare card, they have Part A and Part B and youre selling them a plan, youre initial commission is $510, give or take.
If they already have a plan and youre flipping them, youre making a change or lets say they have a prescription drug plan and youre enrolling them in a Medicare Advantage plan, your commission is going to be half at $255, give or take.
My magic number of total Medicare Advantage policy sales for new agents is 500.
I tell my agents, Wait till you get to 500. At 500, youve built a pension!
At 500 policies, you make a little more than $10,000 a month. And even better, you can handle the book alone because the service work is minimal.
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What To Expect On Your First Presentation
DD: Lets imagine we have an agent selling Medicare insurance. Theyve done AHIP and certification for the carriers as well as a lead program set up. Theyre running their very first presentation.
Whats the experience like the first time theyre in the field?
What can you tell an agent whos going to get started in this business what they can expect on their first presentation?
LM: First, seniors are very nice people to deal with. Even if you just tell them, David, this is my first appointment. Theyre going to help you out, so its just an easier segment of the population to deal with.
Theyre not in a hurry, youre probably in their home. Sometimes Ill have 10 cups of coffee because their hospitality is great.
You go to somebody younger, its like you get in and get out, its business, Lets take care of business. I got to go.
With seniors theyve got time on their hands. So its usually nice to slow down, theres not a lot of pressure.
Agents Need Someone In Their Corner
The only time Im not going to answer is when Im with a customer. Other than that, Im usually going to pick up the phone or Im going to reply to a text and Im like you, Im a workaholic. I work all the time.
Im at home and Im working. Im pitching softball and I got my phone with me. Im out there.
I know you guys are meeting with customers throughout the day and in the evening.
So messaging, email, or call me.
Im also working on creating a YouTube channel where Im going to put scenarios out. So you may call me and tell me, Hey, Ive got a customer thats in this scenario.
So Im going to try to teach you how to fish as opposed to just giving you fish because at some point theres only so many fish I can give you.
Ill teach you where to go find the answers. Thats my job. I dont benefit one bit if these agents dont sell, so I want to help you sell.
Medicare is not a hard product to sell. Again, theyve got to have it. Thats the beauty.
Life insurance is, in my opinion, a much harder sell. Youre selling a piece of paper with a guarantee if something happens their family is going to get money.
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How Much Does Medicare Part B Cost
Q: How much does Medicare Part B cost the insured?A: In 2021, most people earning no more than $88,000 pay $148.50/month for Part B. And in most cases, Part B premiums are just deducted from beneficiaries Social Security checks.
The Part B premium increase from 2020 to 2021 was smaller than initially projected, thanks to a short-term government spending bill that was enacted in the fall of 2020, and that included a provision to cap the increase in the Part B premium for 2021.
How Much Does Medicare Part A Cost
Medicare Part A, or hospital insurance, covers a variety of services, such as:
Home health care
Skilled nursing facility care
One benefit of Medicare Part A is that most enrollees don’t pay a monthly premium. You’re eligible to sign up for Part A starting three months before the month you turn 65, and up until three months after you turn 65.
Whether or not you’ll pay a monthly premium for Part A typically depends on your work history. As long as you’ve worked at least 10 years in the US, the equivalent of forty quarters, you can get Part A at no cost.
If you’ve worked less than 10 years, you’ll pay a premium depending on the number of quarters worked. For example:
If you’ve worked 30 to 39 quarters in the US, your Part A premium is $252 per month.
If you’ve worked less than 30 quarters in the US, your Part A premium is $458 per month.
Keep in mind other costs are associated with Medicare Part A, too. You’re responsible for certain out-of-pocket costs, which are determined by the length of your hospital stay. Here’s what you can expect to pay:
$1,408 deductible per benefit period
Days 1 to 60: $0 coinsurance per benefit period
Days 61 to 90: $352 coinsurance per benefit period
Days 91 and beyond: $704 coinsurance per “lifetime reserve day” after 90 days per benefit period
Once you’ve exceeded the lifetime reserve days, you’re responsible for all costs.
Is There Help For Me If I Cant Afford Medicares Premiums
Medicare Savings Programs can pay Medicare Part A and Medicare Part B premiums, deductibles, copays, and coinsurance for enrollees with limited income and limited assets.
Reviewed by our health policy panel.
Q: Is there help for me if I cant afford Medicares premiums?
A: Yes. Medicare Savings Programs can help with premiums and out-of-pocket costs.
Medicare Part D Premium
Medicare Part D is optional prescription drug coverage, available as a stand-alone Medicare Prescription Drug Plan that you enroll into to augment your Original Medicare coverage or through a Medicare Advantage Prescription Drug plan.
Although Medicare Part D is offered by private Medicare-contracted insurance companies, the government still sets an income-related monthly adjustment amount. Heres a breakdown of the Medicare Part D payment adjustments . Please note that you typically pay your Part D premium regardless of income level the amount in the far right column is the income adjustment payment.
|Your income if you filed an individual tax return||Your income if married and you filed a joint tax return||Your income if married and you filed a separate tax return||You pay your Medicare Part D premium, plus this amount|
|$85,000 or less|
Your Medicare Part D income adjustment payment is typically deducted from your monthly Social Security benefit it isnt added to the premium bill you get from the Part D Prescription Drug Plan. If you have to make an adjustment payment, youll get a notice from Social Security.
If youre charged the income adjustment payment outlined above for Medicare Part B but your income has dropped, you can contact the Social Security information and apply to reduce your adjustment amount.
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How We Help Agents Earn Top Medicare Commissions
At Senior Market Advisors, we give our agents the tools they need to succeed. When you partner with us, you have the opportunity to sell plans from all of the major carriers and maximize your potential to make money. Youll also gain free access to our proprietary CRM and have an experienced sales and marketing team to help your business grow. Ready to start? Call 1-844-452-5020 or eContract with us today.
Medicare Part B Premiums
Medicare Part B premiums are calculated based on a persons modified adjusted gross income . For purposes of Part B premiums, your MAGI is the adjusted gross income you report on line 11 of your federal tax return, plus any tax-exempt interest income, such as municipal bonds earnings.
Current year Medicare Part B premiums are based on MAGI reported on your tax return from two years earlier. For example, 2021 Medicare Part B premiums are based on MAGI reported on 2019 federal tax returns.
|Medicare Part B Premiums|
|More than $412,000||$504.90|
Beginning in 2007, Medicare began charging higher-income beneficiaries more for their Part B coverage. This charge is called the Income-Related Monthly Adjustment Amount . Medicare Part D, which provides insurance coverage for prescription drug costs, also charges a monthly premium that is based on an IRMAA.
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What Is Commission Like
DD: Lets talk about commissions. Can you expand upon what the commission structure is like and how if at all an agent can increase his commission level?
LM: Commissions are very easy to grasp. You either get full commission when you enroll somebody in a Medicare Advantage plan for the first time, or youre going to get half.
This year, a first-time enrollment pays $510.
If I write the plan in April, I get paid in May.
Starting the following year I receive renewal commissions at half the $510 payout, which is $255 total for the year, paid as earned.
Im paid that renewal income as long as the clients remains on the books.
DD: For the sake clarifying for agents wanting to know more about commissions, this assumes a client you wrote last year was a first timer to Medicare Advantage so you got the full $510?
DD: The renewal commission thats paid out in Mat, is that the whole $255 or is it as-earned at that point?
LM: Good question. Its as-earned. Youre going to get one-twelfth of that $255, so youll get that every single month.
Some agents think that isnt much but when you build a book of business thats a steady income coming every single month.
You can budget your life because you know whats going to come in every single month, give or take a little bit, but its not a huge commission that youre getting on an individual basis.
Finding Out If You Qualify
With so many different programs providing assistance for so many different types of costs, its easy to get confused. Fortunately, there is help available to find out if you qualify for financial assistance for Medicare.
A good place to start is with BenefitsCheckup.org, a free online tool from the National Council on Aging that connects older adults with benefits they may qualify for. Insurance brokers and state-area offices on aging are also excellent resources.
Dont be afraid to reach out for help in finding out if you qualify for assistance paying for your Medicare coverage. After all, youve earned it.
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Chasing The Mdpp Money
Do it right and the MDPP can really pay off
When discussing Medicare’s Diabetes Prevention Program with health club managers, they eventually always ask me: How much money can we really get back from Medicare on this program? Here are some insights into how this program can be a lucrative offering to positively affect your bottom line.
Working with a Medicare reimbursement schedule is often new territory for fitness clubs. First, lets get a handle on what reimbursements are possible and then well talk more about the full revenue impact of the program.
|Total Reimbursement for Entire Program||$670||$195|
Under the heading of making hay while the sun is shining, you can see that the potential to earn reimbursements from year one is the highest. Your initial time investments are higher but participant engagement is likely to be higher during that first year, too. Therefore, it’s crucial to capture early enthusiasm to help cement a new healthy lifestyle and keep them coming back for the program sessions. Participant retention is going to be a key marker to watch as your program ages and more people are moving through the phases.
Additional Revenue: Consider Offering a Fitness Program
So How Much Can I Expect?
Lets take a look at a simple model to see potential revenue for a 10-member cohort using some industry averages for membership fees and other charges:
Are There Resource Limits
The short answer is yes.
Your income and resources both need to fall below a certain amount in order for you to qualify for Extra Help. Resources are things like savings accounts, stocks, IRAs, bonds, and real estate thats not your primary home.
Your home, your car, and any valuables you own dont count as resources. Medicare also wont count large payments, such as the payout from a life insurance policy or a tax refund.
To qualify in 2021, your resources cant exceed $14,790 as an individual. If youre married, you need to have combined resources of less than $29,520 to qualify.
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Qualified Medicare Beneficiary Programs And Medicare Advantage
If youre currently in the QMB program, you can enroll in a Medicare Advantage plan. There are unique plans for those with Medicare and Medicaid. A Medicare Advantage Special Needs Plan for dual-eligible individuals could be a fantastic option. Generally, there is a premium for the plan, but the Medicaid program will pay that premium.
Many people choose this extra coverage because it provides routine dental and vision care, and some come with a gym membership. While not every policy has these benefits, there may be one available in your area!
Q How Do I Join A Managed Care Organization
A. After being notified that you are eligible for Medicaid , you will receive in the mail a packet of information about the different MCO plan options for receiving your Medicaid benefits. You may choose any plan described in this mailing. You probably want to choose a Managed Care Organization to which your doctor belongs. If you need help making this decision, call the Health Benefit Manager at the phone number in the mailing.
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How Much Does Medicare Supplement Insurance Cost
If you’re enrolled in Original Medicare, there’s also the option to sign up for a Medicare Supplement insurance plan.
These plans are designed to cover some of the costs that Medicare doesn’t. Also known as a Medigap policy, the plan pays most of your out-of-pocket expenses like copayments, coinsurance and deductibles.
Medicare Supplement insurance varies by state, with up to 10 Medigap plan options in 47 states. It’s important to know that starting January 1, 2020, Medicare Supplement insurance plans sold to new Medicare enrollees will no longer pay Part B deductibles. Because of this change, Plans C and F will no longer be available to those newly enrolled in Medicare.
You can, however, keep your plan or purchase one of these discontinued plans if you enrolled in Medicare prior to January 1, 2020. The best time to get a Medigap plan is within six months of turning 65.
Not Picking The Right Medigap Plan
If you buy a Medicare supplement plan within six months of enrolling in Medicare Part B, you can get any plan in your area even if you have a preexisting medical condition. But if you try to switch plans after that, insurers in most states can reject you or charge more because of your health. It’s important to pick your plan carefully. See How Preexisting Conditions Can Affect Medigap Insurance for more information on choosing a plan.
Some states let you switch into certain plans regardless of your health, and some insurers let you switch to another one of their plans without a new medical exam. Find out about your state’s rules and the plans available at your state insurance department Web site. You can also find more information about medigap policies in your area at Medicare.gov.
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Medicare Extra Help Income Limits
- Extra Help can help you pay for Medicare Part D if you have limited income and resources.
- Part D is the part of Medicare that covers prescription drugs.
- As an individual, you must make less than $19,320 and have less than $14,790 in resources to qualify.
- If youre married, you and your spouse will need to make less than $26,130 in total income and have less than $29,520 in combined resources.
If you need help paying for the costs of your Medicare Part D prescription drug plan, you might qualify for assistance through a program called Extra Help. To qualify for Extra Help, you need to meet certain financial requirements.
Read on to learn about Medicares Extra Help program, including this years income limits, how to qualify, enrollment information, and more.
When you have a Medicare Part D plan, youre responsible for monthly premiums, deductibles, copayments, and coinsurance amounts.
Medicare Extra Help can help you pay some or all of those costs.
The program is overseen by the Social Security Administration and is based on income. The SSA estimates that program participants can save as much as $5,000 per year.