Understanding Medicare Part D Coverage and Enrollment Options

There are two ways to get prescription drug coverage through Medicare. One way is with Part C coverage, which is available through a PPO or HMO plan. These plans offer the same benefits as Part A and Part B coverage as well. Part D coverage is used separately from Original Medicare or PFFS plans and a few other types. A Part D plan only covers prescription drugs. Participants can enroll in Part D plans by mail, by phone or online. If a person is enrolled in a Medicare Advantage plan or Part C and enrolls in Part D, that individual will be removed from Part C coverage and returned to Original Medicare.

What Part D Covers Every prescription drug plan from Medicare has a list of covered drugs. Prescription drugs are placed in separate tiers based on their prices. Low-tier drugs usually cost less than drugs in higher tiers. There may be instances where a prescriber insists that a patient use a high-tier drug instead of a low-tier alternative. If this is the case, it may be possible to ask for an exception and have a lower copay obligation. Formularies may change each year based on Medicare’s guidelines. When changes involve a currently used drug, the plan must provide written notice of the change 60 days before the change takes place. Notification may be made by direct contact or when a patient requests a refill of the affected drug.

Part D Cost and Enrollment There is an annual deductible that must be met. In addition to this, policyholders pay a premium and any coinsurance costs. There may also be costs for extra help, late enrollment and coverage gaps. Drug plans vary in price depending on the plan, whether the patient uses in-network pharmacies, the drugs used and whether the patient receives extra help. While plan participants do not have to enroll in Medicare again every year, there are certain time frames when initial enrollment and changes are permitted.

Part D with Other Coverage Some people have existing plans with companies other than Medicare. When there is an existing plan with another company, it is best to consider the benefits of both before switching. For government health insurance such as VA benefits, federal employee benefits, Tricare or Indian health benefits, it is best to keep federal coverage. Contact any programs used such as food stamps, HUD or SSI to see how Medicare works with benefits.

People who are newly eligible for Medicare should start planning their enrollment as soon as possible. It is important to be aware of the open enrollment period where changes and initial enrollment are allowed. To learn more about Medicare Part D plans and what options are best for individual needs, discuss concerns with an agent.

Where Will You Live If Your House is Destroyed, and How Much Will It Cost?

Where will you live?

When a house is destroyed, the people who lived in it naturally think about the lost possessions. They think of lost furniture, clothes, photos, entertainment systems, and so on. And then the realization sets in: They have to find another place to live. Will it cost more to live there than they’re used to paying?

Sometimes people are put out of their homes temporarily. For example, a severe windstorm may blow a tree down and leave it on (and in) the house’s roof. No one will be able to use the upstairs until that tree is removed and the damage repaired. Similarly, flood waters on the first floor may render the entire home uninhabitable. Until the water is pumped out and repairs made, the occupants will have to live elsewhere. These temporary dislocations may last anywhere from a few days to a month or two. It depends on the extent of the damage and whether contractors are available to do the work.

In more severe events, the occupants may never be able to return to the home. Every summer, wildfires in the western states burn homes to their foundations, leaving nothing for the owners to return to. Some catastrophic weather events, like the tornado that hit Joplin, Missouri in 2011 or Hurricane Katrina in 2005, left rubble where the houses had been. Occupants of these homes had to relocate permanently or at least temporarily while they rebuilt.

Depending on what happened, it may be difficult to find a new place to live. If the incident was isolated to a few properties, finding temporary homes should be relatively simple. For example, if one home burned down or a few homes in one neighborhood suffered flood damage, there should be short-term apartment and hotel room vacancies nearby.

If a widespread catastrophic event occurred, such as a hurricane or extensive flooding, displaced residents may find themselves competing with one another for a fixed number of vacancies. The less expensive places will rent out quickly, leaving those affected to choose from rooms that are more expensive, some distance away from their original homes, or both. Superstorm Sandy in 2012 left thousands of people in this situation.

Most homeowners’ and renters’ insurance policies provide “loss of use” or “additional living expense” coverage to help their policyholders cope at times like this. It pays the difference between the residents’ normal monthly housing cost and the cost of the replacement quarters. For example, if a family was paying $1,000 a month for rent, and their temporary apartment costs $1,500, the insurance will cover the additional $500.

Homeowners policies do not cover all events, however. They do not cover flood or earthquake damage, for example. If a flood drives a family out of its home, the insurance will not help them rent a more expensive residence.

If you are unsure whether you have this coverage, talk to your insurance agent. Losing your home, even for a few weeks or months, is a shock. Having insurance to help you get through will make the blow a little easier to take.


Is Getting Older the Secret to Happiness?

It may seem illogical, but in order to be truly happy, you need to age. The years between 60 and 80 are the time when the majority of people are the most joyful, according to a recent survey conducted for bank HSBC.

So how do all of these people in their 60s and 70s find the key to happiness? It starts with obvious factors such as good health and a respectable standard of living; but even these don’t make as large a contribution to one’s happiness as you might think. In fact, there aren’t really any external factors that play a part in making people happy. Happiness is a natural outcome of aging that originates from within. That’s because the frequency with which negative feelings occur actually declines as you advance in years; and when they do happen, they don’t last as long as when you are younger.

Of course, the level of happiness you achieve varies according to the individual. Your genetic makeup influences how happy you will be, as does your parents’ happiness. Your health can influence how content you are, too. People who are severely ill aren’t as happy as those in excellent health. But that’s true at all ages. The odd thing is that when researchers compared the morale of frail older adults to younger adults, the older adults beat the youngsters in the happiness department hands down, in spite of their infirmity.

The reason older adults can remain happy is probably related to their desire to make the most of the time they have left. Knowing that the clock is ticking makes people figure out the things that make them angry, and then either learn how to avoid them, or what they can do to cope.

Researchers also noted that brain function changes with aging. Brain imaging studies found that older peoples’ brains react less strongly, and for a shorter period of time, to negative feelings. They concluded that one’s improved outlook on life is probably a combination of changes in perspective, and changes to the amygdalae, a part of the brain that processes emotion.

Another change that comes with age is less emphasis on how much money one has. Money only seems to have any real importance for those who are struggling to meet their every day expenses. People that have a steady stream of income for life, no matter how small, learn to adjust to their new financial circumstances and find contentment.

Finally, continuing to engage in activities that you feel are important will add to your happiness. These activities need to be things that make a contribution like taking care of a grandchild, doing volunteer work, or working in a second career. Getting involved is life enhancing, and a little appreciation of life’s simple pleasures goes a long way on the road to happiness.


Preventing Business Disruption

A recent report from MassMutual showed that the company was interested in learning the needs of its customers, and expressed its continued commitment to meeting the needs of business owners and customers. The company’s Business Owner Perspectives Study helped researchers better understand the marketplace needs of MassMutual’s customers. HawkPartners helped conduct the study for the benefit of MassMutual and consumers. For those who read the study, there are several opportunities to learn how to overcome challenges and enjoy success. The study explored several planning pillars of importance. These included the following:

  •   Knowing the worth of the business.
  •   Ensuring loyalty among key employees to the company.
  •   Transferring of ownership or looking for a buyer when retirement time approaches.
  •   Protecting the company from the death or permanent disability of a key worker or an owner.
  •   Deciding who will take the lead for the business if one of the owners dies, leaves or becomes permanently disabled.

In the study conducted by MassMutual, one of the most interesting findings was that business owners in the United States spent most of their time handling operations of their business instead of working on improving the business. This is considered working in the business instead of on it, and the concept of working on a business instead of in it is an important topic today. With most business owners, long-term planning is not always their top priority. However, all business owners agree that protecting the company is their key goal. Both negative and positive emotions are connected to business planning. With more plans in place, the rate of positive attitudes among business owners increases.

MassMutual encouraged business owners to review this study with key employees. They also encouraged family members to review it together to help create a useful dialogue about protecting a business and ensuring its long-term survival. Since a business is important for the livelihoods of family members, communities and employees, business owners must put forth the effort to make sure it is properly protected. MassMutual pointed out that entrepreneurial businesses were important components of a recovering economy. Since the economy is still bouncing back from a slump, they encourage all business owners to avoid sacrificing the financial futures of their families and workers. It is possible for business owners to look past what they perceive as overwhelming daily demands of running a business. By doing this, they can build and accomplish their long-term financial goals. To learn more, discuss concerns with an agent.