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Medicare Enrollment FAQ

Posted on April 1, 2013 by Barbara Bontemps in Health Insurance, Medicare, Medicare Insurance

Whether you are about to turn 65 or already enrolled in Medicare, there are some basic things you should do to be sure you get the most out of your coverage. Here are some of the most frequently asked questions..

 1.   I am about to turn 65. When can I enroll in Medicare? You can sign up for Medicare anytime within the 7 month interval starting 3 months before your birth month. If you were, for example, born on April 5, your enrollment window is between January 1 and July 31.

2.    How much will Medicare cost? In an earlier blog posting http://www.breedloveinsurance.com/medicare-basics/ we reported that you usually don’t have to pay a premium for Medicare Part A. For 2013, Medicare Part B costs $104.90 per month – more if your income is higher than $85,000 (or $170,000 if you file taxes jointly).

3.    What if I don’t sign up? There will be a 10% penalty for each 12-month period that you could have had Part B and didn’t sign up for it. You will have to pay higher premiums for as long as you have Medicare.

4.    I’m eligible for health coverage based on employment. Can I delay signing up for Medicare? If you have health coverage as a result of your or your spouse’s employment, you may not want to sign up for Medicare. You should follow the rules for that plan. Some plans allow you to defer signing up for Medicare Part B, which will save you the cost of the Part B premiums. However, note that you should sign up for Part B if employment ceases. Getting COBRA or retiree coverage will not let you defer Part B.

5.    I am receiving Social Security benefits but am not yet 65 years old. Can I get Medicare? You will be automatically enrolled in Medicare when you are eligible. If you are not disabled, this will be 3 months before your 65th birthday. If you are disabled, it will be on the 25th month of your disability.

6.    Do I need anything more than Medicare? This is something we should discuss in depth. Medicare alone does not cover prescription drugs and Part B only covers 80% of the costs of things like doctor visits and outpatient services, including cancer treatments. The cost of this co-insurance can mount up if you get sick. That’s why many people opt to purchase a supplemental insurance policy to cover these expenses.

Bay Area, healthcare, Medicare, Retirement Planning No Comments Read More

Healthy Living: Wine Country Day Trip

Posted on April 1, 2013 by Barbara Bontemps in General, Healthy Living, Preventive Health

Springtime is a great time for biking — and one of the most enjoyable rides we’ve taken on our tandem two-wheeler is along Dry Creek Road and over to the Alexander Valley in beautiful Sonoma County.  This route is a relatively flat, picturesque jaunt that features lovely vineyards (and wineries!), a gourmet market for picnic supplies, and the charming amenities of Healdsburg.  Whether you travel by bike or car, this day-trip is sure to please.

Start your day in Healdsburg, which is in the heart of this wine producing region. It is a charming town, with many tree-lined streets with fine old homes and a vibrant downtown arrayed around its classic town square. While it bustles with many inns, restaurants and shops to cater to tWest Dry Creek Roadhe visitors, it retains its small-town charm. Begin at Healdsburg City Hall on Grove Street, a couple of blocks from the town plaza.  Go south on Grove and then right on Mill, which becomes Westside Road as it leaves town and ducks under Hwy 101.

Westside is a wonderful cycling road: just a straight, flat run up to a right turn onto West Dry Creek Road. It is at this corner that the ride really begins. West Dry Creek Road is probably the most popular cycling road in the area. It has all the right elements: It is rolling and meandering, not hard enough to be brutal, but not easy enough to be boring. There is lovely scenery and usually pleasant weather. It follows its up-and-down course for nine miles heading north up the narrow valley. The valley floor to the right is all vineyards, while on the left, the steep hills are covered in dense fir and oak forest. In amongst the wineries and vineyards are many residential properties, ranging from modest cottages to high-end estates.Dry Creek Wineries

When the nine miles of West Dry Creek come to an end, turn right on Yoakim Bridge Road and cross the valley to Dry Creek Road. Dry Creek Road and West Dry Creek run north and south, parallel, one on each side of the valley. Dry Creek is smoother, wider, and busier.  There is more traffic, but the road has wide shoulders where riders can enjoy a little elbow room. Continue on Dry Creek just past Dutcher Creek Road to one of our favorite stops — Ferrari-Carano Winery.  It’s not only known for its great wines, its gardens are spectacular at this time of year.  Enjoy a stroll and maybe a tasting or two! Return to Dry Creek and head south, turning left onto Canyon Road.

Canyon Road is the biggest climb of the day. It is neither difficult nor very steep, just 2.2 miles rising 200 feet.   The descent into the Alexander Valley is shorter and steeper and almost straight. At the bottom, the route turns right on Geyserville Avenue and rolls into the town of Geyserville, a sleepy little village that hasn’t changed too much over the years. Zipping through town, cross the Russian River on a long, new bridge, and head south on Hwy 128. As with West Dry Creek, there are no significant climbs or descents and, in fact, what little ups and downs there are will be soft and easy.

 Leave Hwy 128 for a left turn onto Geysers Road. If you are driving, you can head up into the high country to view the Geysers, but on the tandem we use this segment to connect to Red Winery Road, a quiet bypass off 128.  At its end, Red Winery tees into Pine Flat Road. Here you take a right onto a short, flat section that returns you to Hwy 128. Turn right on 128 and roll along for just a few hundred yards to a rest stop at the famous Jimtown Store, built in 1895.
Jimtown Store
This is a regular stop for cyclists passing this way and a favorite among food, wine and travel writers.  In 1989, former Silver Palate partner, John Werner, and his wife discovered the store while visiting from New York City. After learning it was for sale, the couple bought, restored and reopened the general store and filled it with everything you could want for a gourmet picnic in the wine country. For cyclists, there is a hose bib where you can refill your water bottles. Comfortable chairs and bike racks are available so you can rest a spell.  And there is a great deli inside with sandwiches made to order – also a vast array of cheeses, beautiful produce and, of course, gourmet coffee.

The last leg of the journey heads west on a short section of Hwy 128 onto Alexander Valley Road. Re-cross the Russian River and ride uphill to a right turn onto Lytton Station Road. In a little over a mile on Lytton Springs Road turn right again, cross under Hwy 101 and begin a small climb.  At the summit, turn left on Chiquita Road and begin descending—gently—through more vineyards. There are two short but rather steep rises on Chiquita, each followed by a descent. They are probably the two steepest pitches on the entire ride, but they are both very short.

At the bottom of the last descent, you’ll see the Healdsburg city limit sign, where the population density increases. Chiquita tees into Grove, where the route turns right and heads south into the city. Grove is a quiet, low-traffic alternative to Healdsburg Avenue, the busy main drag through town. Past some light industry and apartment/condo complexes you enter a pleasant, shady neighborhood of older, handsome homes. Finally, head downhill slightly and roll out in front of City Hall, where you began the ride.

 

 

 

 

 

Bay Area, healthy living No Comments Read More

Pre-Existing Conditions No Longer a Condition Starting January 2014

Posted on March 26, 2013 by Barbara Bontemps in General, Health Care Reform, Health Insurance

Long-Awaited Relief: Patient-BP

One of the most anticipated elements of the Affordable Care Act will take effect January 1 of 2014: Anyone with a pre-existing condition — be it physical or psychological — can no longer be denied health coverage. The sun is setting on insurers’ ability to exclude a pantheon of minor to serious afflicions and with this comes up to 25 million newly insured into the healthcare system.
 
According to an analysis by the Department of Health and Human Services, 50 to 129 million (19 to 50 percent of) non-elderly Americans have some type of pre-existing health condition. Up to one in five non-elderly Americans with a pre-existing condition – 25 million individuals – is uninsured. In addition, as many as 82 million Americans with employer-based coverage have a pre-existing condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease. A percentage of these individuals — whether through job changes, divorce or other life events – may also be looking for new coverage come 2014.
 
With full implementation of the Afforable Care Act, insurers can no longer carve out needed benefits, charge higher premiums, set lifetime limits on benefits, or deny coverage due to a person’s pre-existing condition.  Here’s the rundown:
  • Insurers can no longer use health status to determine eligibility, benefits, or premiums;
  • Insurers can no longer limit lifetime coverage to a fixed dollar amount;
  • Insurers can no longer take away your coverage because of a mistake on an application;
  • Insurers can no longer deny coverage to a child because of a pre-existing condition.

It’s a new and welcome dawn for those who have struggled to obtain health coverage because of their health history.

 

 

 

 
 
Bay Area, California Healthcare Exchange, employer healthcare requirements, health insurance, healthcare, Healthcare reform, women's health No Comments Read More

Top 5 Reasons for Using an Agent

Posted on March 26, 2013 by Barbara Bontemps in Health Care Reform, Health Exchange, Health Insurance, Medicare Insurance

Surf’s Up! Now You Can Shop Online! With the new Covered California health insurance exchange soon to be available to consumers, you might wonder why you need an agent to help you in your search for the best health plan. After all, it’s just a matter of surfing the internet, right? Wrong! There are bound to be some hidden undertows associated with this sea change in health coverage and the last thing you want is to get caught in a dangerous current. Here are the best reasons for letting an agent help you navigate what could be some turbulent waters:Agent Consult

1.     Breadth of Knowledge: A licensed agent will have a breadth of knowledge you don’t – about all the different carriers and plans (including Medicare), costs and comparisons, and about which of all of these (given your specific circumstances) would be the best fit for you. 

2.     Impartiality: As with most large businesses, insurance carriers have their own corporate culture and their own emphasis when it comes to health coverage.  Some focus on HMO plans, some on individuals and families, some on older clientele.  Independent agents don’t affiliate with a specific health insurance carrier, so they can put your interests first and choose the carrier and plan that makes the most sense for you. 

3.     Understanding of Rules and Regulations: Agents must be licensed and now certified to be able to sell coverage to you – whether inside or outside of the Covered California health exchange or whether it’s Medicare Supplements and drug plans.  This means they must understand all the new rules and regulations surrounding health care, be aware of the consumer protections that must be followed, as well as the requirements insurers and employers must meet.

4.     Customer Support: Your agent is your advocate – and sometimes it’s helpful to have another person in your corner watching out for your interests and handling some of the day-to-day management of plans when you hire a new employee, change your plan or add a dependent.

5.     Affordability: There is no charge for using an agent! There are not many service-oriented businesses that can make that claim.  Healthcare and health coverage are one of the most important facets of one’s life.  Why not consult a professional to help you obtain the best possible coverage for you, your family and/or your business ?

Affordable Care Act, Bay Area, California Healthcare Exchange, Covered California, health insurance, healthcare, Healthcare reform, insurance exchange, Medicare No Comments Read More

Getting Covered in California: Are You Ready ?

Posted on March 26, 2013 by Barbara Bontemps in Health Care Reform, Health Exchange, Health Insurance

Covered California – the state’s new health insurance exchange (marketplace) is up and running full steam ahead toward full implementation in OcCovered California logotober of this year.  At that time, health insurers will have their new plan offerings in place and consumers will be able to shop for and compare plans to suit their needs and finances.  It is aniticpated that there will be a flood of new enrollments which must be completed by March 31 of 2014.

In preparation for this “health coverage cliff,” Covered California has already defined the basic tiers of coverage it will offer and their respective costs.  It has also defined who can qualify for the government subsidies and tax credits that will be offered, as well as the penalties that will be imposed for non-compliance.

Whether you are an individual or small business owner, you need to know what’s ahead and how to prepare.  Here are some FAQ’s we think you’ll find helpful…

Frequently Asked Questions for Individuals & Families

Frequently Asked Questions for Small Business Owners

Will you qualify for tax credits or subsidies ?  Individuals can use this online calculator to determine whether their household income meets the threshold for receiving assistance through Covered California.  Small business owners can review the Tax Credit Fact Sheet for guidelines.

Whether you acquire coverage through Covered California or not, the marketplace for health insurance is going to become increasingly competitive and finding the right plan will be challenging.  Remember that we can help you navigate the waters of this sea change.

 

Bay Area, California Health Insurance, employer healthcare requirements, health insurance, healthcare, insurance exchange No Comments Read More

Let the Sun Shine In: The Important Role of Vitamin D

Posted on March 26, 2013 by Barbara Bontemps in General, Healthy Eating, Healthy Living, Preventive Health

 Vitamin D — the “Sunshine Vitamin” — is one of those vitamins that have long been taken for granted.  People believed that taking it in supplements was unnecessary since our bodies synthesized it from the sunlight.   But research has shown that Vitamin D deficiencies are common and that this once largely ignored nutrient plays an important role in many metabolic functions and in disease prevention.Sunshine

Data collected from the National Health and Nutrition Examination Survey (NHANES), found that 9% (7.6 million) of children across the U.S. were vitamin D deficient, while another 61 percent or 50.8 million, were vitamin D insufficient. “We expected the prevalence of vitamin D deficiency would be high, but the magnitude of the problem nationwide was shocking,” says lead author Juhi Kumar, M.D., M.P.H., a fellow in pediatrics at Children’s Hospital at Montefiore Medical Center, The University Hospital and Academic Medical Center for Albert Einstein College of Medicine.

The most common forms of Vitamin D are D2, which must come from food or supplements and D3, which the body manufactures from UVB wavelengths. It is only when the UV index is greater than 3 that these UVB wavelengths are present. A UV index of more than 3 occurs every day in the tropics; in temperate zones it occurs every day during some of spring, all of summer, and parts of autumn; and it occurs hardly ever at all in the arctic circles. Humans require ten to fifteen minutes of sun exposure at least twice a week on the face, arms, hands, or back without sunscreen with a greater than 3 UV index for adequate amounts of vitamin D3 to be produced. Interestingly, longer exposure doesn’t increase the body’s reserves of Vitamin D.  In fact, too much exposure results in the extra vitamin supply being degraded as fast as it is generated.

 So what do we need Vitamin D for?

  • It is crucial for the absorption and metabolism of calcium and phosphorous, which have various functions, especially the maintenance of healthy bones.
  •  It is an immune system regulator.
  •  A study published in September 2012 suggested that low levels of vitamin D may increase the risk of heart attack and early death.
  •  It may help the brain to keep working well in later life, according to a study of 3000 European men between the ages of 40 and 79.
  •  It is linked to maintaining a healthy body weight, according to research carried out at the Medical College of Georgia.
  •  It can reduce the severity and frequency of asthma symptoms, and also the likelihood of hospitalizations due to asthma, researchers from Harvard Medical School found after monitoring 616 children in Costa Rica.
  •  It has been shown to reduce the risk of developing rheumatoid arthritis in women.
  •  A form of vitamin D could be one of our body’s main protections against damage from low levels of radiation, say radiological experts from the New York City Department of Health and Mental Hygiene.
  •  Various studies have shown that people with adequate levels of vitamin D have a significantly lower risk of developing cancer, compared to people with lower levels. Vitamin D deficiency was found to be prevalent in cancer patients regardless of nutritional status, in a study carried out by Cancer Treatment Centers of America.
  •  It may reduce the risk of developing multiple sclerosis. Multiple Sclerosis is much less common in the tropics where there is much more sunlight, according to Dennis Bourdette, chairman of the Department of Neurology and director of the Multiple Sclerosis and Neuroimmunology Center at Oregon Health and Science University, USA.
  •  High vitamin D doses can help people recover from tuberculosis more rapidly, researchers reported in September 2012 in the Proceeding of the National Academy of Sciences (PNAS).

 So, next time you visit your doctor, have him/her check your levels of Vitamin D – and get out into the sunshine!

Bay Area, healthy living, preventive care, women's health No Comments Read More

Covered California — The New State Health Exchange

Posted on February 6, 2013 by Breedlove Insurance in Health Care Reform, Health Insurance

A New Mandate and a New Marketplace: Covered California

The Affordable Care Act stipulates that states must establish health “exchanges” or marketplaces where consumers can shop for now-mandated health insurance coverage. The exchanges will specifically offer basic affordable plans for individuals and small businesses meeting certain eligibility requirements and will offer subsidies for coverage, as well.

California is one of the first states to receive federal approval to proceed with the establishment of its exchange — called “Covered California,” which will officially launch in October of this year, but plans for it have been underway since 2010, when then-Governor Arnold Schwarzenegger signed AB 1602 and SB 900 into law creating the California Health Benefit Exchange.

As defined by the legislation, the exchange is a “quasi-governmental organization…an independent public entity not affiliated with any state agency or department” and it is governed by a 5-member board, all of whom have expertise in some aspect of healthcare: individual or small business health coverage; health benefits plan administration; and health care finance. Two members are appointed by the governor, one by the Senate and one by the Assembly. The Secretary of Health and Human Services Agency serves as an ex-officio voting member. Members serve four years and no board member may be affiliated in any way with health insurers, agents or brokers, providers,, facilities or trade associations — nor may they be health care providers (unless they receive no compensation).

The Board is advised by three key stakeholder advisory groups that were created to inform them on policy issues and help with the Exchange’s implementation. These include: Plan Management and Delivery System Reform; Marketing, Outreach and Enrollment Assistance; and the Small Employer Options Program. The Board is also pro-actively working with state Native American tribal organizations to maximize their participation in the exchange.

One of the major tasks that must be accomplished by October is the certification of Qualified Health Plans (QHPs) to be offered through Covered California. All health insurers must go through this certification in order to offer coverage on the exchange. QHPs are required to provide essential health benefits and services, provide cost-sharing, and will have a designated “metal” tier —Platinum, Gold, Silver or Bronze. Health insurers must offer at least one plan at each of the four coverage levels whether or not they choose to participate in the exchange. The Covered California Board will determine the basic benefits covered in each tier and has the authority to go beyond the federal minimums and impose additional requirements.

Concurrent with the establishment of QHPs and the exchange for individuals, the state will also be setting up a Small Business Health Options Program (SHOP) exchange for small business owners, which will make it easier for them to offer affordable health coverage for their employees — and allow for a broader range of plans and coverage that up to now have only been available to large employers. Initially, the SHOP will be limited to those with 50 or fewer employees. Covered California estimates that there are as many as 375,000 small businesses will become eligible for the 50 percent federal tax credit offered through the SHOP — an big encouragement for participation.

Once the QHP offerings are determined, Covered California will implement its consumer assistance, education and outreach efforts to increase awareness and understanding among the estimated estimated 5.6 million uninsured as to what their health coverage options are. 

By next October, all elements of Covered California must be up and running for what is expected to be a very busy and intense open enrollment period. 

Affordable Care Act, California Health Insurance, California Healthcare Exchange, Covered California No Comments Read More

February is American Heart Month

Posted on February 5, 2013 by Breedlove Insurance in General, Healthy Eating, Healthy Living, Preventive Health

Heart disease is the leading cause of death among women – more deadly than all forms of cancer combined.  For this reason, the American Heart Association has proclaimed February “American Heart Month” with an emphasis on their “Go Red” campaign to prevent and cure heart disease.  Find out your risk factors and what what you can do to prevent heart disease.

healthcare, healthy living, preventive care, women's health No Comments Read More

Take Away that Winter Chill with Chili!

Posted on February 4, 2013 by Breedlove Insurance in General, Healthy Eating, Healthy Living

Whether you prefer a three-alarm version or one that’s on the milder side, here is a vegetarian recipe guaranteed to warm you on a cold winter evening!

Chili with Black Beans and Bulgur

1 tsp olive oil
1 large onion, chopped
1 red bell pepper, chopped
1 jalapeno pepper, seeded and finely chopped
1 tsp cumin seeds, ground – toast seeds before grinding
¼ tsp cayenne (add more if you like a little or a lot of  kick)
3 cups vegetable stock (perhaps more, but start with this amount)
1 15 oz. can diced tomatoes
2 oz bulgur
1 15 oz can black beans, drained and rinsed
1 cup frozen corn kernels
3 oz grated cheddar cheese for garnish
1. In a nonstick soup pot or sauce pan heat olive oil over medium heat.  Add onion, red pepper, jalapeno, cumin and cayenne.  Saute  vegetables until soft; about 8 minutes.
2. Add stock, tomatoes and bulgur.  Simmer 30-40 minutes until bulgur is fully cooked.  Add black beans and corn and cook an additional 10 minutes.
3. Top with cheese and serve with corn bread.
This recipe serves 6-8. Chili can be made up to 3 days in advance and refrigerated or stored in the freezer for up to a month.  You may need to add more stock when reheating.
healthy living, healthy recipes No Comments Read More

Starting Now — Seven Changes to Social Security

Posted on February 4, 2013 by Breedlove Insurance in General, Investment, Retirement Planning, Savings, Social Security, Uncategorized

Rule Changes You Need to Know: The Social Security Administration has implemented seven new rules and features for 2013.   Here’s the rundown:

1.  Tax cap increase: The payroll tax cap has gone up from $110,100 to $113,700 — an increase of $3,600 for 2013.  Workers who earn more than this threshold do not need to pay Social Security taxes on that income.

2. No more payroll tax cut: The temporary payroll tax cut expired at the end of 2012.  Individuals who paid 4.2 percent of their income into Social Security during 2011 and 2012 will now pay 6.2 percent up to the $113,700 tax cap.

3. Reduced office hours: To save money and reduce overtime expenses, Social Security offices are reducing the number of hours they are open to the public.  Since last November, Social Security offices around the U.S. started closing 30 minutes sooner each day and, as of January 2 of this year, they close to the public every Wednesday at noon.

4.  A boost in online services: Commensurate with the reduction in office hours, the Social Security Administration is providing more services online.  You can now claim Social Security payments online, access your statements, and view your complete earnings history and expected payments.  In addition, you can input a change of address and request direct deposit of your payment — all online.

5. No more paper checks: That online request for direct deposit is going to come in handy on March 1, 2013, when the Treasury Department will stop sending out paper Social Security checks. Recipients will have two choices for payments: electronic direct deposit into a bank or credit union account or a prepaid Direct Express Debit Mastercard forwarded in the mail.

6.  Higher earnings limit for those still working: Those who are between 62 and 66 who still work and collect Social Security at the same time might have all or part of their benefits temporarily withheld.  Working people between ages 62 and 65 can earn up to $15, 120 in 2013 — above which $1 will be withheld for every $2 of income above the earnings limit.  People who turn 66 this year may earn up to $40, 080, after which $1 will be withheld for every $3 earned. Once you turn 66, however, the earnings limit no longer applies and benefits may be recalculated to reflect the withheld benefits and continued earnings.

7. Bigger payments at last: Starting in January, Social Security recipients began receiving payments that are 1.7 percent higher — with the average payment going from $1,240 to $1,261 thanks to a long-awaited cost-of-living adjustment.

older workers, Retirement Planning, Savings, Social Security No Comments Read More
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