I’ll by no means forget the day my Aunt asked if I could help her choose her Medicare plan. Truly how challenging could something like this be? Well, take your worst visit to the Dentist and multiply it by 10.
How in the world does the government expect anyone to comprehend this? After years of coaching and knowledge in the office I assumed I had experienced it all, apparently not.
First, there’s the unrelenting stream of advertisements that kicks off just about six months before one turns 65. There were so many things being sent by mail we practically had to buy a new mailbox. To start with it was somewhat amusing but it started to get old real fast.
You simply would not believe the number of phone calls. You would feel somebody had just come into a huge sum of money! Followed by the assortment of ideas from neighbors who all supposed that this Medicare Advantage plan or that Supplement was the only choice that makes sense. The guy at the post office even seemed to deem that he alone recognized what the only worthwhile Part C Advantage plan in California is?
I was naive enough to assume that we could simply call the government to obtain help. Let me tell you now, that is absolutely not an option. I don’t even want to tell you the incredible number of sales agents we met with. Funny thing, they all thought something different! So after much frustration and an unplanned meeting we achieved our purpose. The following information is a succinct outline of what we found out.
As soon as your Medicare card shows up it will confirm that you will have Parts A and B. Part A covers hospital and B addresses physician’s office visits. Because Medicare just covers up to 80% it is always your responsibility to figure out how to pay the left over 20%. Furthermore, there are co-pays, deductibles and co-insurance. There are numerous coverage options you can make a choice from to take care of this. You enroll in one of these programs 3 months sooner than you become 65, then it will start the first day of your birth month.
Then there’s Part D which is absolutely not obtainable by Medicare, but instead through private insurance agencies. Part D is assumed to be elective. The dilemma is that if you don’t enroll in one, you will receive a late enrollment penalty. For each month that you do not have a Part D prescription plan you will pick up a 1% penalty, 36 months = 36%.
Quite simply it comes down to 2 main options, lets discuss the first. One can buy a Medicare Supplemental and in addition get a Part D. These will together have a per month premium. The advantage to this option is freedom. You can go to any health care professional in the U.S. that participates in Medicare. There is no copays or co-insurance. This is definitely the more costly way to go and the price will most likely increase on an annual basis.
The other alternative is to select one of the Medicare plans in California. This option is also recognized as Part C. They incorporate benefits for A, B and D of Medicare in one package. These plans vary by county. Several plans have no per month premium. Selected plans include particular co-pays and others contain very few. These are by and large HMO’s so you have to only see doctors within the plan’s network.
Every year during the annual enrollment period you get the opportunity to swap your insurance coverage. This time is between October 15th to December 7th. Medicare Supplemental policies are quite different. They are guaranteed issue as soon as you first get on Medicare. Following that you may or may not be able to acquire one.
We were going to just give up in frustration when we had the chance to speak with a friend of our neighbor. She was just in from Paso Robles. She appeared to possess an unusual understanding of not only the Medicare program but the varied selections. We were surprised. It took her around 10 minutes to make clear something that had taken us six months to realize.
She had the luck of contacting an independent Licensed Healthcare Specialist. These individuals work together with each insurance carrier in the state. They only work with Medicare programs. And since they represent so many insurance companies they don’t care who you choose as long as you’ve chosen the top decision for your specific situation. They are more educators than salesmen.
The finest part? They won’t charge a penny for their guidance. They’re compensated directly by the insurance carriers. The rate to somebody is precisely the same as if going directly with the Medicare plan. I only wish I could have known previously that people like this were accessible to me.
Our endeavor finally ended up really well. I am now sure that the next moment somebody asks me I know just what say to them.
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