Facts You Need About Medicare Supplement Insurance

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Facts You Need About Medicare Supplement Insurance

By Laura Kinart

WisMed Assure Account Executive

The best time to explore and understand Medicare Supplement Insurance is well before you turn age 65.

Medicare Supplement Insurance is health insurance that pays some of the health care costs that Medicare doesn’t cover. This includes costs like coinsurance, copayments, and deductibles among others.

The ins and outs of Medicare and supplement insurance can be confusing, and it is best for you to seek advice from an insurance expert who takes the time to fully understand your current situation and the future needs of you and your family.

Because WisMed Assure is the only insurance agency in Wisconsin working exclusively with physicians and the healthcare community (healthcare is our only business), we may be your best choice when it comes time to figure out what you need to do about Medicare and Medicare Supplement Insurance.

Our knowledgeable staff understands Medicare and supplement insurance. Even more importantly, we hold ourselves accountable for giving you everything you need to make the best decisions and feel confident while doing so.

A starting point in decision making is to pick the right company to work with. At WisMed Assure we partner with Wisconsin Physicians Service Insurance Corporation, commonly known as WPS, to provide what we feel are the very best supplement insurance options.

WisMed Assure and WPS have common roots, we were both started by the Wisconsin Medical Society; WPS in 1946 and WisMed Assure in 1981 (We were originally known as Wisconsin Medical Society Insurance and Financial Services, Inc., we took on our new name in 2019.)

Here are some important facts for you to consider:

  • Medicare alone is not enough, you need to make sure you have a supplement to fill in the gaps that Medicare leaves.
  • Medicare Supplement Insurance can be used anywhere in the US, so there is no worry of having “out of pocket” charges.
  • Coverage begins on the first of the month that you turn 65 and/or enroll in Medicare Part B, or on the effective date you request up to three months in the future.
  • If Medicare Covers it, so does the Supplement!
  • WPS has a local customer service center to help out if needed and they give you the help you need, quickly and accurately because they only work with supplements.
  • WPS offers a 7% discount to households with two members on a WPS Medicare Supplement.
  • In 2019, WPS Health Solutions was named one of the World’s Most Ethical Companies® for the 10th year in a row by the international Ethisphere® Institute.
  • Optional Dental Coverage is available
  • Silver & Fit program is available on base plans which provides discounts to local gyms as well as discounts on fitness products.
  • All WPS Medicare supplement insurance plan customers receive access to the EyeMed Vision Care discount program at no additional cost.  EyeMed offers substantial savings on eye care and eyewear at thousands of provider locations nationwide.
  • Hear in America program is also available to all WPS Medicare Supplement insurance plan customers – offering discounts on hearing aids (which are not covered by Medicare).
  • Profits earned by WisMed Assure directly support the mission and vision of the Wisconsin Medical Society.

If it is time for you to explore, understand and make the best possible decisions about Medicare and Medicare Supplement Insurance, it’s time to call WisMed Assure.

Laura Kinart

Account Executive

Wismed Assure

D: 414-238-6106

E: laura.kinart@wismedassure.org

Click here to visit the WPS website.

Resources to Navigate Stimulus Loans & Utilize Telehealth in Your Practice

Greetings,

We are passing along a communication sent today by the Wisconsin Medical Society about two resources we are making available to members and non-members to help support their service during this pandemic.  We apologize if you are receiving this twice. 

Many of our clients have asked about help with the following: Navigating all the Federal Acts and small business loan opportunities related to COVID-19 Moving services to a Telehealth platform You can find details for both these opportunities below.

Warm Regards,

Shawna Bertalot, CIC, ACI
President
WisMed Assure

Dear Colleague,

The Wisconsin Medical Society is working to support health care professionals through this crisis. We have partnered with organizations to develop resources to help you care for your patients and manage your business. Two such opportunities can be found below.

Webinar – How the Stimulus Can Help You

As the COVID-19 crisis continues, there are wide-ranging resources available for physicians and health care professionals. However, identifying which resources would benefit your health care practice is difficult. The Wisconsin Medical Society (WisMed), gener8tor and WisMed Assure are here to help protect your practice and your employees.

Join gener8tor, WisMed and WisMed Assure for a free webinar about the government resources available to independent physicians and health care practices, as it relates to the stimulus package.

Here are just some of the great topics that will be covered:

  • Which federal grant/loan programs is my business eligible for?
  • SBA Disaster Loan (e.g. Economic Injury Disaster Loan or EIDL)
  • CARES Act and the Paycheck Protection Program (PPP)

Register below to receive the link for the live webinar.

When: April 7 at 7 a.m.

The webinar will be made available as a COVID-19 resource on the Society’s website after the event.

Register

Telehealth

The Wisconsin Medical Society has partnered with Valet Health, an innovative health care digital marketing company, to offer a streamlined – and HIPAA compliant – telehealth start-up service during the coronavirus pandemic.

As a part of this partnership, the following fully managed services are being made available:

  • Startup fee is waived ($350 value)
  • Room set-up (create a virtual waiting room, the dedicated space for where clinicians will see patients during a telehealth visit)
  • How-to documentation
  • An email communications template to educate patients about the availability of telehealth visits
  • A website banner notification for telehealth appointments for WordPress websites
  • Telehealth template page for patient education
  • $75 per month per clinician charge for continuation of service, if desired

It is imperative at this time to be inclusive in our efforts to overcome this virus; therefore, the Society is offering this service to members and nonmembers.

Please click below to learn more or contact Jim Lorence with questions.

Learn More

Covid-19 Crisis Prompts OCI Guidance to Insurers

Coverage flexibility encouraged for group benefits, telemedicine and temporary providers

By Christopher A. Noffke, GBDS

Insurers are being asked to allow small employers of physicians and other healthcare workers (2 – 49 employees) to extend healthcare coverage to employees who work less than 30-hours per week or are furloughed due to Covid-19.

The Commissioner, Mark Afable, issued a bulletin on March 26 that, “encourages insurers to make available the option of maintaining coverage under the group insurance plan for employees working fewer than 30 hours to those employers who wish to do so.”

The bulletin also, “encourages insurers to work with employers to provide the option of continuing dental, vision, and prescription drug benefits when offered as separate policies.”

With a stay at home order in place until at least April 24, this is an important development for small groups. And, if insurers follow these recommendations, it will eliminate the need to change providers or incur new deductibles and cost-sharing requirements once the crisis has passed and employees return to full-time work.

Telemedicine and temporary provider professional liability coverage

In a separate bulletin issued on March 31, OCI made it clear that insurers should do everything they can to help.

“At the direction of Governor Tony Evers, Insurance Commissioner Mark Afable issued a request to medical malpractice insurers today aimed at expanding access to telemedicine during the COVID-19 pandemic and at ensuring retired and out-of-state health care workers can get the medical malpractice coverage in order to support the state’s response to COVID-19.”

Bud Chumbley, MD, MBA and CEO of the Wisconsin Medical Society said, “It is extremely important for insurers to act now as all of Wisconsin steps up to the plate to minimize the severity of this crisis.”

What next?

Both of these bulletins where prompted by inquiries made to the OCI from members of the medical community as well as a significant amount of advocacy by the Society and its insurance company WisMed Assure.

This is a fluid situation as insurers react to these recommendations. If you want to get the most up-to-date information about your insurance coverage, please contact me.

Chris Noffke GBDS                                        
Director of Group Benefits                     
WisMed Assure      

608.442.3734 direct                                       
00.975.3421 toll free                    
608.442.3811 fax                                                                        
chris.noffke@wismedassure.org  

Physicians Testing Positive for Coronavirus

Disability coverage for physician who test positive for coronavirus is available through our Association Group Long Term Disability insurance contract with MGIS/Sun Life.

We are acutely aware that all of our Wisconsin Physicians involved with direct patient care are at risk of testing positive for COVID-19. At a time when the coronavirus is causing concern for all of us, a physician’s ability to provide for their families if they could not practice because of testing positive should be the last of their worries.

So, this is to let you know that we have a special Group Long Term Disability contract for Physicians. It is the strongest in the nation with one of the strongest insurers in the market.

There is more good news for you: if you currently are not insured with Sun Life, consider switching. Because of our negotiated association contract, we may be able to provide you a lower insurance premium.

And, of course, unlike any other Agency, our profits go directly to the Wisconsin Medical Society and are put to work for you.

The following documents from insurance carriers provide greater detail about disability coverage eligibility.

To learn more, please contact Chris Noffke or Dave Serena.

Chris Noffke GBDS                                         Dave Serena
Director of Group Benefits                          Group Disability Specialist
WisMed Assure                                           WisMed Assure
(608) 442-3734                                            (414) 238-6105
chris.noffke@wismedassure.org                dave.serena@wismedassure.org

NOTE: We also work with the “Big 5” Personal Disability Insurers (Standard, Principal, Berkshire/Guardian, Ameritas, and Mass Mutual) and have asked them if their “personal” disability policies would pay benefits.  So far, we have heard different responses from “testing positive” by itself would not be covered to responses using terms like “may” and “probably”.

Is Your Money Unemployed? Replace budgeting with goal setting and give your money a job

By Christopher Rufus Sweeney

“If you are willing to live like no one else will early in life, then you can live like no one else can later in life.”

James Dahle, MD, “The White Coat Investor”

As we developed our financial literacy course for medical students, my colleague Emma Crawford and I initially called the first module “Budgeting”.  We quickly realized no one likes to create a budget much less stick to it. So, we changed our perspective and called the module “Budgeting: Goal Setting”.

Goal setting is all about giving your money a job… a very empowering activity. And, to add a little sugar to the medicine, we’ve replaced the “b” word altogether and use “earmarking” instead.

Emma and I created this course to give medical students a scaffolding on which to build their futures… financial and otherwise. Goal setting and earmarking challenges you to do three things:

  1. Determine and rank the values that drive you
  2. Decide the goals that are most important for you to achieve
  3. Make sure your spending habits reflect your values and goals

These steps are simple to understand, but they are perhaps some of the most challenging to live by. There are plenty of studies about the psychology of why we struggle with these but one published in the Journal of Consumer Psychology is particularly helpful. It’s titled, “If money doesn’t make you happy, then you probably aren’t spending it right” and it is available on sciencedirect.com. The title speaks for itself.

When determining your values and identifying your goals, one key takeaway from the study may be very helpful: Buy experiences instead of things. Because we quickly get used to new things, the happiness we experience is fleeting. With experiences, new and repeated, the happiness we experience is much more enduring.

Another key takeaway is easy to say but extremely difficult to do: Pursue your own goals, not anyone else’s. This is where your values come in; when you are very clear about what they are, and you review them often, they protect you from getting caught up in someone else’s definition of what’s important in life. (The quote by James Dahle, MD at the beginning of this article speaks to the reward you can expect when you stick to your values.)

Once you have your values and goals, you need to decide how to earmark your money. Here is a simple table with my spending categories to help you get started.

  NON-NEGOTIABLE NEGOTIABLE
FIXED Housing
Transportation
Insurance
Savings 		Subscription streaming services
Amazon Prime
VARIABLE Food
Gasoline 		Hobbies
Nights out
Vacation

There are a number of very good online resources to help you set up, manage and stick to your goals. In the course, we run through a detailed explanation of how to use an app called Mint. Without actually going online to do so, here are some of the soundest steps you can take to give all of your money the job of ensuring you achieve your goals:

  • Look at your personal history of spending. (With apps like Mint, you track your credit and debit card activity)
  • Track your spending back at least a month… preferably six months
  • Assign categories of spending for all transactions
  • Once you know how much you spend on average, you can refine or create new categories of spending as needed
  • Set a monthly budget and identify where you can cut back if needed
  • Keep track of how you’re doing on at least a weekly basis

What do you learn from tracking your expenses? First, you learn where all your money is going. Without a doubt, you will be surprised at how many different ways you spend money and, most importantly, how little much of your spending contributes to the achievement of your goals. In other words, you learn how to recognize when you are spending money towards the achievement of someone else’s goals (increasing Starbuck’s income comes to mind).

The best result of earmarking is it gives you a clear picture of what you can do to accelerate your progress to your bigger longer-term goals. The sense of power and satisfaction even the smallest step towards those bigger goals is invigorating and an acknowledgement of your ability to be in control of your money instead of suffering as your money controls you.

Next blog:

Live Like a Resident: If you live and work like a resident, you can become financially independent in 10-12 years. That feels good.

What’s Next for Physicians, Clinicians and Health Systems? the Coronavirus and Your Insurance.

Healthcare Insurance

Most if not all insurance companies are waving first-dollar (co-pay, deductibles, co-insurance) for diagnostic testing. Other costs will likely apply depending upon your plan and needs. We will update you if any significant changes occur.

Short-Term Disability

If you are sick and unable to work for more than the number of days specified in your policy (typical terms are 0,1,7,14 or 30 days), a Short-Term Disability claim will be approved and paid. But, if you are quarantined for more than the number of days stipulated in your policy – quarantine typically lasts two weeks – but do not contract the virus, your Short-Term Disability insurance would not pay.

Long-Term Disability

The important number here is, like Short-Term Disability, the number of days specified in your policy (the shortest is 30 days but it can be 60, 90 or more). If you contract the virus and are unable to work for longer than the number of days stipulated in your policy, you will most likely be eligible for compensation.

Workers Comp

Filing a workers compensation claim if you are unable to work because of Coronavirus quarantine or actual illness is tricky. You would have to be able to prove you actually contracted the virus at your place of work. Since it is similar to a flu, insurance companies are likely to treat it as such and your claim would most likely not be approved.

Business Interruption Insurance

Business interruption insurance is designed to replace income that is lost due to an event that causes business to be halted or interrupted due to damage to the business physical property, such as a fire or hurricane or other natural disaster.  Policies differ but most specify what kind of event would trigger coverage.  Additionally, most policies have coverage for when a civil order prevents access to the property.  Many policies “contingent business income coverage” if business cannot continue due to a loss experienced by a third party, such as a critical supplier.  None of these triggers or policy coverage language specifically address an event like we are experiencing now with COVID-19.  Ultimately, coverage will depend on how the facts are applied to the policy language.  

What’s Next?

What’s next indeed! We know physicians, clinicians and health systems are on the frontlines in this battle. That’s why we are doing everything we can to make sure we are here for you. We are actively monitoring our teams’ health and updating plans to provide best service possible if they can’t come into work.  All of our staff has the ability to work from home.

We are also actively monitoring coverage policies and watching for any changes from our insurance company partners.

Warm regards,

Shawna Bertalot, CIC, ACI,

President

To address any questions or concerns, please contact Christopher A. Noffke, GBDS

Director of Group Benefits.

608.442.3734 direct

Chris.Noffke@wismedassure.org

PS: The Johns Hopkins Coronavirus Resource Center hosts a website dynamically tracking cases around the world. Despite the increase in cases worldwide, a visit to the site shows how China was able to relatively quickly “flatten the curve” by enacting public health and safety measures. I think this is a very good indication of how quickly we will be able to eliminate this threat.

What’s Next for Physicians, Clinicians and Health Systems? The Coronavirus and Your Insurance.

As of today, here’s what we can safely tell you about Short-Term Disability, Long-Term Disability, Workers Comp, and business interruption insurance.

Please Note: The following information is general. Specific circumstances may impact how your insurance works. If in doubt about claims related to Coronavirus, contact your insurance agent.

Healthcare Insurance

Most if not all insurance companies are waving first-dollar (co-pay, deductibles, co-insurance) for diagnostic testing. Other costs will likely apply depending upon your plan and needs. We will update you if any significant changes occur.

Short-Term Disability

If you are sick and unable to work for more than the number of days specified in your policy (typical terms are 0,1,7,14 or 30 days), a Short-Term Disability claim will be approved and paid. But, if you are quarantined for more than the number of days stipulated in your policy – quarantine typically lasts two weeks – but do not contract the virus, your Short-Term Disability insurance would not pay.

Long-Term Disability

The important number here is, like Short-Term Disability, the number of days specified in your policy (the shortest is 30 days but it can be 60, 90 or more). If you contract the virus and are unable to work for longer than the number of days stipulated in your policy, you will most likely be eligible for compensation.

Workers Comp

Filing a workers compensation claim if you are unable to work because of Coronavirus quarantine or actual illness is tricky. You would have to be able to prove you actually contracted the virus at your place of work. Since it is similar to a flu, insurance companies are likely to treat it as such and your claim would most likely not be approved.

Business Interruption Insurance

Business interruption insurance is designed to replace income that is lost due to an event that causes business to be halted or interrupted due to damage to the business physical property, such as a fire or hurricane or other natural disaster.  Policies differ but most specify what kind of event would trigger coverage.  Additionally, most policies have coverage for when a civil order prevents access to the property.  Many policies “contingent business income coverage” if business cannot continue due to a loss experienced by a third party, such as a critical supplier.  None of these triggers or policy coverage language specifically address an event like we are experiencing now with COVID-19.  Ultimately, coverage will depend on how the facts are applied to the policy language.  

What’s Next?

What’s next indeed! We know physicians, clinicians and health systems are on the frontlines in this battle. That’s why we are doing everything we can to make sure we are here for you. We are actively monitoring our teams’ health and updating plans to provide best service possible if they can’t come into work.  All of our staff has the ability to work from home.

We are also actively monitoring coverage policies and watching for any changes from our insurance company partners.

Warm regards,

Shawna Bertalot, CIC, ACI,

President

To address any questions or concerns, please contact Christopher A. Noffke, GBDS

Director of Group Benefits.

608.442.3734 direct

Chris.Noffke@wismedassure.org

PS: The Johns Hopkins Coronavirus Resource Center hosts a website dynamically tracking cases around the world. Despite the increase in cases worldwide, a visit to the site shows how China was able to relatively quickly “flatten the curve” by enacting public health and safety measures. I think this is a very good indication of how quickly we will be able to eliminate this threat.

Group Health Insurance Slam Dunk

A three-point strategy for winning big

By Chris Noffke, GBDS, Director of Group Benefits

“A little March madness may complement and contribute to sanity and help keep society on an even keel.”

If Henry V. Porter, the high school coach who wrote this in 1939, could see how powerfully March Madness grips our nation today, he might have second thoughts about its effect on our sanity… not to mention the alignment of our collective keel.

When it comes to group health insurance, deciding when and how to pivot from one insurance company to another can be as maddening as filling out your bracket ahead of the big dance. Anyone who has wagered even the smallest of amounts, knows how difficult it is to choose the winners among the 68 teams in the tournament. Despite the countless strategies hyped by all sorts of experts, winning most often comes down to plain luck.

But, unlike choosing your March Madness bracket, developing and sustaining a successful employee benefit plan doesn’t have to be a toss-up. You can tilt the court in your favor by following this three-point strategy.

Point #1: Always be shopping

When it comes to staying ahead in the health insurance game, maintaining status quo is the fast lane to self-defeat. Instead, by carefully shopping around each year and being prepared to change, you can spot opportunities for significant savings.

That’s because insurance prices tend to follow a multi-year pattern. Generally speaking, insurance companies offer better rates to entice new groups to switch plans. They then gradually bring the premiums for those plans back up to a more profitable level… this takes between two and four years.

I’m not saying you should change insurance companies every year. But, by shopping around every year, you will be able to compare your plan costs to what is available on the market. At some point, you will see a significant difference between the renewal you’ve been given and what is available elsewhere in the market.

This strategy can benefit both small and larger employers and their employees. The difference maker here is a proactive, knowledgeable insurance advisor. Think of your advisor as a scout who is always on the lookout for the best talent.

Point #2: Know your benchmarks

Large or small, your organization is competing for employees against other employers. That’s why it is essential to constantly monitor the benefits types and benefit levels being offered in your area by similar companies. You need to know if your benefits are going to attract the best players to your team.

Here again, a proactive insurance advisor is your best ally. Speaking from experience, the ability to provide healthcare-only benchmarking across our entire customer base gives our clients a big competitive edge in attracting and retaining talent while controlling costs. Regardless of where you get your benchmarking data, it is important to drill down as deeply as possible to find the specific data most relevant to your business.

Point #3: Innovate your game plan

A company with the right medical plan is a lot like a basketball team with strong fundamentals; no team wins without excellent dribbling, shooting, passing, and rebounding. But, these skills alone are not enough to make it to the Final Four. To be the best takes something special; a secret sauce of team spirit, creative leadership and great individual talent.

Your success in attracting and retaining the best possible employees also depends on your ability to offer a fundamentally sound health plan. Exploring and understanding all options for how benefits are paid – from medical gap coverage, HSAs, HRAs, flex spending and many more – and then choosing what is best for your organization is essential. (E.g.: Recently, by altering how the employees paid their deductibles, we helped a client with 60 enrolled employees save over $100,000 on their annual insurance premiums.) 

But, just like in basketball where fundamentals are essential but not enough to win the tournament, to succeed as an employer, you need something special. Truth is, the vast majority of employees want access to voluntary benefits because they cover what may otherwise become a personal financial issue that distracts them from their work.

Renewal madness

Because it never actually ends (unlike March Madness), playing the employee benefits game isn’t about winning year-to-year, it’s about playing to the best of your ability. Bob Knight, one of the winningest coaches of all time said it best: “Discipline is doing what has to be done, when it has to be done, as well as it can be done, and doing it that way all the time.”

At WisMed Assure, we carry out these three points every year, for every client. They simply give us their employee census and we do the rest. (If you are not – yet – a client of WisMed Assure, we can do the same for you for free if you provide your census.)

I invite you to contact me to explore how these three points can help make your benefit program a winner.

chris.noffke@wismedassure.org

608.442.3734 – direct

800.975.3421