Know the Truths and Half-Truths in Medicare Advice

You are receiving this email because you signed up to receive Bob Carlson's free e-letter Retirement Watch Weekly, or you purchased a product or service from its publisher, Eagle Financial Publications. [Carlson's Retirement Watch Weekly] [Retirement Reports](www.retirementwatch.com/retirement-resources/) [Retirement Articles](www.retirementwatch.com/retirement-articles/) Brought to you by Eagle Financial Publications Know the Truths and Half-Truths in Medicare Advice by Bob Carlson Editor, [Retirement Watch]( 04/07/2024 SPONSORED [Buy and Hold This Dividend Stock Forever… and Leave It for Your Grandchildren]( [image]( This stock is one of those rare finds that you can hold forever and pass down to your grandchildren. It should be a core position in every investor's portfolio—especially with its hefty yield! New FREE report gives you the name of the safest, most reliable, and most consistent dividend stock that pays dividends EVERY month. In addition to paying 12 dividend checks each year, this company has also increased its monthly dividend twice every year for the past 8 years. [Click here to get its name now--FREE.]( [CLICK HERE...]( Fellow Investor, [Bob Carlson]One of the most important decisions for those 65 or older is the choice of Medicare coverage. The first big decision is whether to enroll in original Medicare or a Medicare Advantage plan. There are pluses and minuses to each, and I’ve covered them in detail in past issues of Retirement Watch, episodes of the Spotlight Series and my books. But it’s important to give enough weight to the long-term consequences, and many beneficiaries don’t do that. For example, consider coverage of short term nursing home care. Neither Medicare option covers long term stays in a nursing home that are needed primarily for custodial care. But Medicare does cover up to 100 days in a nursing home or skilled nursing facility that’s needed after being in a hospital for at least three days. This type of care typically is for rehabilitation or recovery after a major surgery or illness. The individual isn’t ready to go home but doesn’t need to stay in a hospital. In original Medicare, you, your doctor and perhaps other medical providers decide whether you should go to a nursing facility and for how long. But when you’re enrolled in an Advantage plan, the plan decides how much rehabilitation is going to be covered. Advantage plans tend to deny, or limit stays in nursing homes compared to the care received by original Medicare participants, according to a recent report from the Kaiser Family Foundation. Government data indicate that nursing home stays are among the services most frequently denied by Advantage plans. Though original Medicare would cover the stays, the Advantage plans can rule them “medically unnecessary” and deny coverage. Another long-term issue is your ability to change from an Advantage plan to original Medicare. The rules allow you to change plans each year during open enrollment, such as by switching from an Advantage plan to original Medicare. But as a practical matter, you could end up with less coverage if you switch. Original Medicare Part B has a number of coverage gaps. The most significant gap, other than prescription drugs, is the 20% coinsurance amount on most types of covered care. You’re on the hook for the 20%, with no dollar limit. That’s why original Medicare participants should obtain a Medicare supplement (also known as Medigap) policy that covers most of the gaps in original Medicare. They also should have a Part D prescription drug policy. In your initial Medicare enrollment period, insurers are required to sell you the Medigap policy of your choice, regardless of your health history. But after the initial enrollment period, the guaranteed issue no longer applies. The insurers can review your medical history or require a medical exam. Based on the results, an insurer can decline to issue you a policy or charge you a higher premium. States can provide additional consumer protections for purchasers of Medigap policies. [URGENT WARNING: Millions of Retirements Are At Risk]( [image]( Congress is spurring on the most dangerous retirement threat of the last 50 years. America’s top retirement researcher reveals the deadly truth behind this government move… Plus the ONLY way to fully protect your wealth in the coming months. [Click Here for the Full Story.]( [CLICK HERE...]( Currently, four states (Connecticut, Massachusetts, Maine and New York) extend the guaranteed-issue rule to Medigap applicants outside their initial enrollment periods. A number of people initially sign up for Advantage plans because they expect lower out-of-pocket costs and want the additional benefits, such as vision and dental care. But some beneficiaries want to switch to original Medicare after they develop health problems, because they want to select their medical providers and don’t want the plan to decide if they can see specialists or have certain tests and treatment. Though Medicare allows a switch from an Advantage plan to original Medicare during the open enrollment period, as a practical matter it might not be available. The beneficiary might not be able to obtain a Medicare supplement policy to cover the gaps in Medicare. If you switch to original Medicare and can’t obtain an affordable Medigap policy, you’ll be responsible for all the coverage gaps in Medicare Part B. That might make the switch unaffordable and compel you to stay in an Advantage plan. You might have a similar problem if you move. Advantage plans are local. There might be an attractive Advantage plan available where you live now. But if you move to another area later in retirement, you must choose from the Advantage plans available in that area. There’s no guarantee an attractive Advantage plan will be available to you. Your best option might be original Medicare, but you might not be able to buy a good Medicare supplement. Or you could sign up for an attractive Advantage plan when first enrolling in Medicare. But the plan could change its terms and be less attractive, or the insurer might stop offering the plan. Again, you must find a new Advantage plan or switch to original Medicare and hope you’ll qualify for a Medigap policy. To a better retirement, [Bob Carlson] Bob Carlson Editor, Retirement Watch Weekly Editor’s Note: Thanks to a little-known loophole in the law, investors can collect between $2,500 and $3,900 per month for the rest of their lives, tax free, even if they currently have ZERO saved for retirement. It’s a retirement strategy unknown to most financial planners, yet it’s 100% legal and approved by the IRS. [Click here to find out more.]( SPONSORED [Learn to Trade Like Interest Rates Don't Matter]( [image]( As February overflows with interest rate headlines, here’s a fresh perspective for you: Learn to trade like interest rates don’t matter. Whether you're a stock trader, options trader, swing trader, or day trader, this A.I. “Brain” is predicting market movements days in advance. [Don’t Miss This FREE Live Class to Learn How >]( [CLICK HERE...]( Want More Retirement Advice? Check out my website, [RetirementWatch.com](, where you’ll find hundreds of free articles covering every aspect of retirement planning. Popular Posts: [Nine Important Things to Know Before Contributing to an IRA]( [How to Help Children or Grandchildren Buy a Home]( [Building the Complete Estate Plan]( [Finding Higher Returns With Low Risk]( New to the Retirement Watch Community: SeniorResource.com Alice writes: "Why did a hospital medical claims division employee ask my husband to sign a form stating that he’s aware that he’s now in his “Lifetime Reserve Days” while he was waiting for his lung/heart transplant? He went into the hospital in December of last year for congestive heart failure. Unfortunately, that’s when he discovered that his heart and lungs could no longer support him. The wait for this double transplant is taking longer than expected. I’m now concerned that the hospital will send him home or to a nursing home. Please explain what he needs to do. He’s covered by Medicare Supplement Plan G and has had no issues with that plan." [Click here for the answer.]( About Bob Carlson: [Bob Carlson]Robert C. Carlson is the author of the books The New Rules of Retirement and Retirement Tax Guide, editor and investment director of the popular retirement newsletter, Retirement Watch, and editor of the free weekly e-letter, Retirement Watch Weekly. Bob is a frequent speaker at investment conferences around the country, and you can also hear Bob as a featured guest on nationally-syndicated radio shows, such as The Retirement Hour, Dateline Washington, Family News in Focus, The Michael Reagan Show, Money Matters and The Stock Doctor. About Us: Eagle Financial Publications is located in Washington, D.C. – only a few blocks from the Capitol. Our products have been helping investors build their wealth for several decades. 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