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News From The Health Insurance Store

Question: I have heard there was a recent court ruling regarding the UPMC/Highmark dispute. Will Highmark Medicare Advantage members still have in-network access to UPMC hospitals in Pittsburgh and Erie after June 30?

Answer: There indeed was a ruling concerning the ongoing battle and it’s extremely important that people understand the implications or lack thereof. The PA Attorney General had petitioned the Court to extend the consent decree past June 30th, which would allow those on Highmark Medicare HMO and PPO’s to continue to have in-network access to UPMC.

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Question: I go into my Doughnut Hole every year. I’ve heard it’s going away in 2020. How will that affect me? I assume this is going to save me money.

Answer: This is a very sour subject with me. It doesn’t appear that anyone knows what’s going to happen regarding the Doughnut Hole in 2020. When doing research for this column, I got conflicting information. Several publications I found stated the Doughnut Hole is completely going away next year and one might come to the conclusion that people will no longer have to pay hundreds or thousands of dollars for drugs while in the Doughnut Hole as they do today. Many other articles I found that were written in 2018 stated it was going away in 2019, which wasn’t true. I have also read others that state it isn’t going away and the cost one pays in the Doughnut Hole will continue to be burdensome. 

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Question: I’m turning 65 soon and my phone won’t stop ringing with people who want to sell me a Medicare plan. I’m also getting an enormous amount of mail. Why is this happening?

Answer: You aren’t the only one who has expressed frustration regarding this. I will answer your question and address how seniors can protect themselves from what I consider to be predatory sales practices as well as unscrupulous agents, who unfortunately are out there.

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Question: I’m going on Medicare soon and was considering a Supplement, but they don’t have dental or vision coverage like Advantage Plans. Can I buy those separately and if so, what company do you recommend?

Answer: This is one of the biggest concerns for those who are going on Medicare or currently enrolled. I’ll tell you the same thing I tell all potential clients. Dental and vision coverage isn’t necessary at all. There are so many other more important factors to consider when making your decision on Supplement vs Advantage Plan. Let me explain.

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Question: How many companies sell Supplements? Which companies and policies are the best?  

Answer: There are almost too many to count but I do keep tabs on them all. However, I’m only interested in enrolling clients with companies who offer lower premiums at policy inception and also keep them affordable over time. I will discuss that in more detail below.

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Erie County Area

1105 West 12th Street, Suite – A
Erie, PA 16501
Phone: 814-920-5275
Fax: 814-920-5276

Fayette/Westmoreland County Area

121 North Pittsburgh Street
Connellsville, PA. 15425
Phone: 724-603-3403
Fax: 724-603-3402

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21 Yost Blvd., Forest Hills, PA 15221
Mailing Address: 128 Forest Hills Plaza, Pittsburgh, PA 15221
Phone: 412-349-8818
Fax: 878-302-3149

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Albuquerque, NM 87121
Phone: 505-200-0069
Fax: 505-200-0073

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We proudly serve the health insurance and Medicare needs of the following Pennsylvania areas:  Connellsville, Uniontown, Greensburg, Mt. Pleasant, Scottdale, Irwin, N. Huntingdon, Murrysville, Monroeville, Plum, Lower Burrell, New Kensington, Pittsburgh, Plum, Oakmont, Penn Hills, Forest Hills, Wilkinsburg, East Liberty, Lawrenceville, Bloomfield, Natrona Heights, Leechburg, Washington, Morgantown WV, Latrobe, Monnessen, Jeanette, Erie, Edinboro, Northeast, Girard, Fairview, Union City, Harborcreek, Corey, Meadville, Waterford,  Ligonier, Kittaning, Somerset, Waynesburg, Fayette County, Westmoreland County, Armstrong County, Butler County, Somerset County, Erie County, Crawford County, Venango County, Allegheny Valley, Pennsylvania

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