Insurance Policy Comparison

The share of fee-for-service Medicare enrollees choosing a Medicare Supplement plan rose to 41.4% in 2022, increasing for the fifth consecutive year. These are among the findings of a recent AHIP report that examines trends in Medicare Supplement insurance and highlights the benefits these policies bring to 14 million seniors and people with disabilities. “Medicare Supplement coverage protects the health and financial security of over 14 million seniors,” said Mike Tuffin, AHIP President and CEO. “Medicare Supplemental policies are a proven and trusted coverage option that protect beneficiaries from high out-of-pocket costs.” The new report describes the various types of Medicare Supplement plans, demographics of who chooses to enroll in these plans, which are the fastest growing plans, and how enrollment breaks down state by state. Key takeaways from the report included: - The percentage of fee-for-service Medicare enrollees purchasing Medicare Supplement coverage grew from 35.4% to 41.4% between December 2017 and December 2022. - More than half (57%) of all fee-for-service Medicare enrollees without any additional coverage chose a Medicare Supplement plan in 2021. Fee-for-service Medicare enrollees without Medicare Supplement were 3 times more likely to have problems paying medical bills compared to enrollees with Medicare Supplement policies. - Two percent of enrollees with Medicare Supplement coverage reported having difficulty paying medical bills in the last 12 months, compared to 6% of fee-for-service Medicare enrollees without Medicare Supplement coverage. - A majority of Medicare Supplement (56%) policyholders are women, while 41% are 75 years old or older. - A significant percentage of Medicare Supplement enrollees are people with lower incomes. For example, 21% have incomes below $30,000.

Concerns about healthcare costs... As well as health, generally, and the uncertainty of it, is one of the top concerns we here from investors nearing or in retirement. Medicare is critical to this equation. Demystifying it and breaking Medicare into parts is step one. In this primer, Chris Kawashima CFP®, ChFC, CWS, EA, CEP on my team introduces Medicare options, including plan types and policies. One key piece of perspective, I think, is understanding the differences between #Medigap (Medicare Supplemental Insurance), which fills "gaps" in original Medicare with 10 standardized Medigap plans labeled Plan A through Plan N with varying degrees of coverage, and #MedicareAdvantage Plans (Medicare Part C), alternative private insurance options to original Medicare offered by medical networks and centralized care. Medicare Advantage is what we see in celebrity television commercials and advertisements, since it's private care. It can make sense for many individuals, if they're willing to use a narrower network of providers with limits on doctors or services out of network. But it's helpful to know the differences. And Original Medicare with a Medigap Plan and a Medicare Prescription Drug Plan (Part D) is still a powerful combination for retirees. Link to the article, Demystifying Medicare for Retirement https://lnkd.in/gpV56CSA

🇺🇸 CONFUSED about TRICARE, VA Health Care, and Medicare once you retire from the military? You are NOT alone. Here’s a simple breakdown many veterans and military retirees wish they had sooner 👇 🎖️ **TRICARE Retiree Coverage** Military retirees can keep TRICARE after retirement, but your coverage may change based on age and Medicare eligibility. 💡 Before age 65: Many retirees use: • TRICARE Prime • TRICARE Select • VA Health Care (if eligible) 📌 TRICARE can help cover civilian care, prescriptions, specialists, and family coverage depending on your plan. Reference: tricare.mil 🇺🇸 **VA Health Care Benefits** VA health care is separate from TRICARE. You may qualify for: ✔️ Service-connected care ✔️ Prescriptions ✔️ Specialty care ✔️ Mental health services ✔️ Hearing aids, prosthetics, and more ⚠️ Important: VA care usually works inside the VA system and is not traditional insurance. Many retirees use BOTH: • VA Health Care AND • TRICARE Reference: va.gov/health-care 🩺 **What Happens at Age 65?** Most military retirees become eligible for Medicare at 65. To keep TRICARE coverage, many retirees must: ✔️ Enroll in Medicare Part A ✔️ Enroll in Medicare Part B Once enrolled, you typically move to: 🇺🇸 TRICARE For Life (TFL) Reference: https://lnkd.in/eituh37v 💥 **How TRICARE For Life Works** For many retirees: 1️⃣ Medicare pays first 2️⃣ TRICARE For Life pays second This can lower out-of-pocket costs significantly for eligible retirees. 💰 📌 Many veterans ALSO continue using VA health care alongside Medicare and TRICARE For Life depending on their needs. Reference: medicare.gov va.gov tricare.mil ⚠️ Every veteran’s situation is different based on: • Retirement status • Disability ratings • Medicare enrollment • Family coverage • Location and providers Always verify your personal eligibility directly with TRICARE, VA, or Medicare representatives. 🇺🇸 Not paid for. Just sharing information to help veterans and military families better understand their earned benefits. #Veterans #MilitaryRetiree #TRICARE #TRICAREForLife #Medicare #VABenefits #VeteranBenefits #MilitaryFamilies #RetiredMilitary #VAHealthcare #VeteranSupport #MilitaryCommunity #DisabledVeteran #BenefitsMatter #MilitaryLife #VeteransHelpingVeterans #HealthcareBenefits #VeteranCare #USA #LinkedInTips

#artofprocurement: Understanding Marine Open Policies: Continuous Coverage for Multiple Shipments How Marine Open Policies can benefit our business: 1 Marine Open Policy A Marine Open Policy is an insurance arrangement designed to provide continuous insurance coverage for multiple shipments of goods over a specified period, typically one year. This type of policy automatically covers all shipments within the terms agreed upon, without the need to negotiate terms for each individual shipment. 2 Seamless Coverage for All Shipments One of the primary advantages of a Marine Open Policy is the seamless coverage it offers. Businesses no longer need to set up new insurance for each shipment, as the open policy covers all consignments that fall within the specified criteria, such as routes, goods types, and shipment methods. 3 Cost-Effectiveness Marine Open Policies can be more cost-effective than purchasing separate insurance for each shipment. By covering all shipments under one policy, companies can benefit from bulk rates and reduced administrative costs, translating into significant savings. 4 Flexibility in Coverage These policies are highly flexible and can be tailored to the specific needs of the business. Coverage can vary based on the value of goods, routes, and transportation methods, ensuring that businesses only pay for the coverage they need. 5 Automatic Coverage Updates As businesses grow and shipping needs change, Marine Open Policies can adapt. Increases in shipment frequency or changes in shipped goods can be automatically incorporated into the policy without the need for renegotiation. 6 Efficient Claims Process In the event of a loss, Marine Open Policies simplify the claims process. Since the insurer already holds all necessary details about the shipments and coverage terms, claims can be processed more quickly and efficiently, reducing downtime for businesses. 7 Mitigates Risk of Underinsurance Regular policies might lead to scenarios where shipments are underinsured if not properly managed. Marine Open Policies mitigate this risk by ensuring that all shipments are covered to the extent required, provided they meet the policy's criteria. 8 Ideal for Regular Shippers Businesses that frequently transport goods, such as manufacturers, exporters, and logistics companies, will find Marine Open Policies particularly beneficial. The ongoing coverage ensures that every shipment dispatched during the policy period is automatically insured, providing peace of mind and allowing businesses to focus more on their core operations rather than on administrative tasks. Marine Open Policies represent a strategic approach to managing risks in the shipping and logistics industry. They provide not just convenience and cost savings but also ensure that businesses have robust coverage without the administrative burden of managing multiple policies.

Attention to detail: Small matters can matter a lot in insurance. Often we overlook these things. I do too. Until today I used to think that the marine loss exclusion under a Bharat Laghu Udham Suraksha (BLUS) policy and Standard Fire and Special Perils policy are the same. They are not. Exclusion 14 as per BLUS policy: “Loss or damage to any Insured Property or any claim which is covered by a marine policy in force at the time of loss or damage, except in excess of the limits of that policy.” General condition 4 of SFSP policy: “This insurance does not cover any loss or damage to property which, at the time of the happening of such loss or damage, is insured by or would, but for the existence of this policy, be insured by any marine policy or policies except in respect of any excess beyond the amount which would have been payable under the marine policy or policies had this insurance not been effected.” The difference is that for BLUS policy, the exclusion operates when there is actually a marine policy covering the situation. But for SFSP, the exclusion operates when the risk is coverable under a marine policy, whether or not such a policy was in force at the time of loss. So the BLUS exclusion is narrower than the SFSP exclusion. How does this apply to a practical situation? A fork lift was being used in a factory to load a box into a truck. The lift gave way and the box fell damaging the cargo of finished goods stuffed inside. There is no marine policy coverage for the box. Now, if the factory is insured under an SFSP policy with impact damage or accidental damage extension, there can still be no claim. Since cargo was being loaded, the transit risk has already commenced. The marine exclusion of the SFSP policy would operate. But if the factory is insured under a BLUS policy, there would be coverage as impact damage of any nature is covered under BLUS policy. The marine exclusion does not apply since there is no marine policy in place.

“Commercial Sense Must Prevail Over Blind Conditions” — SC on Marine Insurance Claim Denial Recently, the Supreme Court made a strong observation that can reshape how we look at insurance contract enforcement—especially in high-stakes industries like shipping. 👉 In Sohom Shipping Pvt. Ltd. vs. Assurance Co. Ltd., The insurer denied a marine claim, arguing that the vessel began its voyage after the monsoon set in, violating a special clause that required the journey to “commence & complete before monsoon sets in.” But here’s the twist: - The insurer knew the voyage schedule. - The vessel had all official clearances. - The insurance covered the monsoon period itself (16 May–15 June). So what’s the point of insuring if the claim gets rejected the moment risk materializes? Supreme Court’s Key Observations: - Strict Conditions Can’t Defeat Commercial Purpose If a term makes the entire coverage meaningless, it loses legal validity. “No permutation or combination could allow compliance with that condition,” the Court noted. - Awareness = Waiver When the insurer clearly knew the route and timeline, they couldn’t later cry foul over the monsoon. - Contra Proferentem Not Always Applicable The clause wasn’t ambiguous, but the Court still didn’t favor the insurer—because the clause made no commercial sense in practice. - No Misrepresentation by Insured The insurer had full knowledge. Blaming the client for lack of “utmost good faith” was held as unjustified. Takeaway for Founders, Freight Companies & Insurance Lawyers: - Don’t accept blanket or vague conditions in policies. - Ensure your intent, route, and timeline are clearly communicated in writing. - Even if a clause seems “clear,” courts will read it in light of commercial realities. Let’s be honest—what good is marine insurance if you can never sail? Case: Sohom Shipping Pvt. Ltd. vs. Assurance Co. Ltd.

This is a letter that I sent out to thousands of my clients - in case they wish to pass it along. You may find it interesting if you're approaching Medicare age or already on Medicare. Dear Patient or parent to our patient, It is that time of the year, again, when Medicare patients or those 64 years or older are constantly barraged with phone calls, letters, and texts trying to convince you to sign up with a Medicare Replacement plan (also called Part C or Advantage plans). There is a REASON why the salespeople want you to switch. They get paid money when you do – so they have a reason to LIE to you. While we cannot legally tell you to get traditional Medicare or not to switch to the Medicare Advantage plans, we can tell you that as your doctor, I would not sign up and I would NOT encourage my own family members to sign up, for several reasons: 1. Salespeople will tell you that if you don’t like the large amounts you’re paying in copays on an Advantage plan that you can switch back to Traditional Part B and they are correct. What they don’t tell you is that if you did that, you will probably NOT be able to get back onto a secondary Medigap plan as they NO LONGER must accept you – and many will not. They must accept you when you turn 65 if you sign up with traditional. They don’t have to if you switch back from Part C to Traditional Part B. 2. The TV personalities like Kelsey Grammar and Bill Shatner and others are not telling you about the amount of copays you will have with Advantage plans when you need a surgery or cancer treatment or other therapies. That can easily get into the tens of thousands of dollars. 3. You’re probably also not being told that the Advantage plans make your doctors get a pre-approval before you are allowed to get certain tests, imaging, CT scans, MRIs, etc – and often… they are not allowing them. The Advantage plans have that while traditional Medicare patients have their doctor make the decision as to what is medically necessary. 4. Last, but not least is that many doctors no longer like having to deal with all of the pre-authorizations and delays with Medicare Advantage plans and many have opted out from them. 5. It is your call – but think about this. You trust us with your medical decisions and as your provider, we deal with all of the insurances daily. We know what we’re talking about.

Medicare Advantage looks affordable. Until someone gets sick. More than half of Medicare beneficiaries are enrolled in Medicare Advantage. Many families do not fully understand the trade offs until care becomes complex. This week we spoke with a family trying to choose a plan for their loved one. The brochures promise low premiums and extra benefits. But the real questions are different. What happens if the specialist is out of network What happens if rehab is denied What happens when prior authorization delays treatment What happens if hospital days are cut short Insurance is not the same as access. Many Medicare Advantage plans rely on narrower networks and utilization controls. When someone becomes medically complex, those limitations can surface quickly. Even with coverage, out of pocket costs can escalate. This is not about fear. It is about clarity. Healthcare should protect seniors. Not surprise them. These choices are not theoretical. They are financial and clinical. If you are seeing challenges with Medicare Advantage in your community, I would value your perspective below. https://lnkd.in/eVVADM8C

Most people don’t know this, but almost every doctor who sees Medicare patients accepts Medicare’s payment rates. In fact, about 99% of all claims are processed on “assignment,” which means the doctor agrees to take the Medicare-approved amount as full payment. That’s why excess charges—the extra 15% a non-participating provider could bill—are rare. On top of that, eight states ban or limit excess charges entirely. This is where Medicare Supplement Plan N makes sense. Instead of paying higher premiums for a benefit you’ll probably never use, Plan N trims the cost by skipping excess charge coverage and adding small copays ($20 at the doctor, $50 at the ER if you’re not admitted). For many retirees, the math works. Lower premiums month after month matter more than guarding against a “what if” scenario that almost never happens—especially when you stick with providers who accept assignment. Plan G covers excess charges everywhere and is still a great choice for frequent travelers or anyone who wants total peace of mind. But if you want solid coverage at a lower price point, and you know your doctors take assignment, Plan N deserves a serious look.

The Power of Medicare Advantage: How Next-Generation In-Home Support Is Changing Senior Care   The future of senior care is not only about living longer, but also about living well. Medicare Advantage (MA) is helping lead this change. Today’s seniors, especially tech-savvy Baby Boomers, want more than a standard approach. They are shaping new ways of independent living and in-home care, built on three main ideas:   Technological Integration for Safety and Connection   Advanced technology is now an essential part of aging in place. ·      Safety Net: Wearables, smart home sensors, and fall detection now do more than just send alerts. They actively help monitor well-being, giving seniors and their families peace of mind. ·      Connectivity: Smart devices help seniors stay in touch with resources, care teams, and loved ones. This reduces isolation and encourages more engagement.   Personalized & Holistic Wellness   The focus is moving from just treating illness to supporting overall wellness. ·      Tailored Plans: Care is shifting from generic services to plans that fit each person’s medical history, lifestyle, and preferences. ·      Total Well-being: This means looking at brain health, personalized nutrition, and social activities, recognizing that health is more than just medical care.   Emphasis on Independence and Dignity   The goal is simple: help seniors age in place the way they want. ·      Care plans are built to help seniors stay independent for as long as possible. ·      This approach helps seniors keep their dignity and thrive in the comfort and safety of home.   Medicare Advantage plans can offer extra benefits, making it possible to cover many of these new services. This includes remote monitoring technology, home safety services, grocery delivery, and even pest control, helping more people access this higher standard of in-home care.   What new, non-clinical benefits have you seen MA plans offer to truly support seniors’ independence and overall wellness at home?   Please share your thoughts below!   #MedicareAdvantage #AlignmentHealth #AlignmentHealthPlan #SeniorCare #InHomeCare #AgingInPlace #HealthTech #HolisticWellness #HealthcareInnovation