Why Are Medicare Advantage Plans Popular?

Medicare Advantage plans seem to be popular. But why? What is the appeal? What is so attractive about these managed care plans? Are they really free? GA Medicare expert Bob Vineyard explains.

medicare advantage popular
Why are Medicare Advantage plans popular?

Why are GA Medicare Advantage Plans Popular

Are you turning 65 and confused about the Medicare process? Why is it so difficult? Why do my friends, and many agents as well, want to push me in the direction of an Advantage plan? Low premiums are attractive. So is “free”. Is there really such a thing as a free lunch?

Medicare Advantage plans are like the Hotel California. You can check in but you may never leave.

Some people turn to Advantage plans when they first go on Medicare at age 65. Low premiums, many are $0. Extra benefits like dental, vision and some have gym memberships. Drug plans are often included in the plan. “One stop shopping”.

What’s not to love?

Why do sick people leave Medicare Advantage plans?

Georgia Advantage Plan Traps

Have you ever bought something and later realized you had no idea how it works? Maybe the sales person forgot to mention key details that might have changed your decision.

If something is too good to be true it probably is.

There is nothing inherently wrong with GA Medicare Advantage plans. You just need to understand what you have signed on for. Here are a few questions you need to ask.

Preferably BEFORE you enroll.

  • Is the plan a PPO or HMO?
  • Do I need a referral to see a specialist?
  • Will my doctor take my Medicare Advantage plan?
  • Are there any out of network penalties?
  • Can I change plans at any time?
  • Can I return to original Medicare and a supplement plan if I want?
  • Does the out of pocket limit include prescription medication?
  • What will my health care really cost if I use an out-of-network doctor?
  • Will my claims be paid if I use a non-par provider?

If you ask the right questions and are satisfied with the responses, the Medicare Advantage plan could be just what you need.

When you enroll in a managed care Advantage plan, the insurance carrier, not Medicare, provides your benefits then reviews, adjudicates and pays your claims.

“No premium” plans are not free. You still have to pay for health care and prescription drugs.

There is no free lunch.

Health care is not free. SOMEBODY pays the bill. Either you or the insurance carrier.

But you knew that all along, didn’t you?

This Doesn’t Look Like Kansas Anymore

Managed care plans often have small provider networks. Fewer doctors. Fewer hospitals. The question is, how much smaller?

A Kaiser Foundation survey found that on average “Medicare Advantage plan networks included 46% of all physicians in a county.” Some plans had fewer than 5 thoracic surgeons, fewer than 5 neurosurgeons and fewer than 5 radiation oncologists.

This isn’t JUST about dollars. It is also about access to health CARE.

Each calendar year brings a new list of approved providers. Will your doctors be included or will they disappear into a dark hole?

Are you willing to change doctors to save money or pay more to keep your doctor?

Are claims submitted by non-par providers covered by your plan?

A recent government report says seniors are more likely to LEAVE managed care plans when they get sicker.

Managed care is great when you enjoy good health. But how much will your plan cost when your health changes dramatically? Can you really afford to be sick?

Medicare Advantage Final Exam

Many who enroll in a managed care plan never really understood how the plans work . . . until they had large claims. Don’t be one of them!

Do you like your current doctor(s)? Would you like to keep him or her?

Can my doctor refuse to treat me if I have a Medicare Advantage plan?

Do you want to direct your own health care, pick your own doctors and hospitals, or would you rather let an insurance carrier do that for you?

Is it easier for you to budget $120 per month to cover almost all of your health care costs or are you OK paying for your health care only as needed?

Could you budget $6,000 per year or more for your health care (not including drugs) if you had to?

How long could you afford to pay that much? One year? Two years? Longer?

Would you trade places with Marsha’s husband?

You can change your Advantage plan every year. Same is true for your drug plan. You can also enroll in original Medicare any time you want without answering health questions.

But if you want to change to a Medicare supplement plan you may need to prove you are healthy. Your best shot at getting a Medicare supplement plan is when you first enroll in Medicare Part B. If you wait until you NEED a Medigap plan you may not be able to get one. That is Catch-22.

Many will only have one chance to enroll in a Medigap plan. Will you be one of them?

Shop GA Medicare rates.

Medicare.

You have questions.

We have answers.

$GAMedicareExpert #MedicareAdvantagePlans #FreeMedicarePlans  #MedicareHMO  #MedicarePPO

GA Medicare Advantage

Medicare Advantage Plans in GA are privately run senior health insurance plans that replace traditional Medicare coverage. Most are either an HMO or PPO and require you to use a doctor or other medical provider that has agreed to the terms and pricing structure for the network.

Medicare Advantage Plans = Fewer Choices

Medicare Advantage Plans have more restrictions and fewer choices than original Medicare and a Medigap plan.

  • If you change to a Medicare Advantage Plan you may find that the doctor you have been seeing for years does not participate in your new plan and will only see you on a cash basis.
  • Medicare Advantage Plans typically have low premiums, in some cases $0. The trade off is higher out of pocket when you need it most.
  • Traditional Medicare and a comprehensive Medigap plan F supplement typically means you have $0 out of pocket for hospital and doctor bills when approved by Medicare.
  • When you have a Medicare Advantage Plan, private insurance carriers, not Medicare, decide which claims will be paid and which will be denied.
  • A large hospital bill that is approved by your Medicare Advantage carrier may leave you owing $3,000 or more once the dust settles.
  • When you want to see a specialist you must first have a referral by your PCP (primary care physician) and that referral must be approved by your Advantage carrier.
  • The rules for Medicare Advantage plans change every year

2014 Medicare Disenrollment Medicare Advantage

Medicare Advantage Pluses

To be fair, there are positive things about Medicare Advantage Plans.

  • Advantage plans may include “extra” benefits such as limited vision or dental coverage
  • Advantage plans require copay’s for doctor visits. Something you won’t find with most Medigap plans.
  • Many Advantage plans include prescription drug benefits. Sometimes the “package” covers the medications you need, sometimes not.
  • If you switch from original Medicare to an Advantage plan and you are not satisfied, you may disenroll during the first 12 months of your Special Enrollment Period (SEP) and return to original Medicare.

Types of Medicare Advantage Plans in GA

Most Medicare Advantage plans will fall in to one of the following categories.

  • PPO
  • HMO
  • PFFS
  • SNP

Bob Vineyard, President of Georgia Medicare Plans, has decided to specialize in GA Medigap plans. We believe the flexibility and overall VALUE of original Medicare and a Medicare supplement plan are superior to the Advantage plans currently on the market. We invite you to compare GA Medigap quotes using our instant online quote engine or ask for a free, no obligation consult.

HMO Advantage Plan

Medicare Advantage HMO plans have strict rules for Medicare beneficiaries. You must play by their rules or else your claim is not covered. This is a summary of the HMO rulebook.

  • You can only obtain care from an HMO approved doctor, hospital, lab or other participating medical provider
  • Your Advantage HMO will only pay for a specialist if you have a referral from your HMO PCP (primary care provider)
  • Some medical procedures require prior written approval from the HMO before they will be covered
  • You have limited rights of appeal if your HMO claim is denied

Bob Vineyard and Georgia Medicare Plans does not recommend Advantage HMO plans to our clients. We believe the choice and value from GA Medigap plans is superior to those offered by HMO plans.

PFFS Advantage Plan

PFFS Medicare plans allow you to see any willing provider but ONLY IF that medical provider accepts the terms and pricing structure offered by your PFFS Medicare Advantage plan.

  • For each medical service (including lab, X-ray, etc.) the provider must accept whatever limits your PFFS carrier places on the treatment plan
  • If the doctor or medical provider does not agree to the terms your medical procedure is not a covered expense and you must pay out of pocket
  • To avoid any penalty, you need to check with each provider BEFORE services are rendered, to see if they still agree to the terms and payment limits of your  Advantage plan
  • You cannot assume that a doctor or service that was covered in the past will be covered the next time
  • Some Advantage plans require you to pay a copay every time you see a doctor or receive a medical service
  • Some PFFS plans have a network just like PPO plans. If you use a non-par provider you pay a penalty.

Bob Vineyard, President of Georgia Medicare Plans, has decided to specialize in GA Medigap plans. We believe the flexibility and overall VALUE of original Medicare and a Medicare supplement plan are superior to the Advantage plans currently on the market. We invite you to compare GA Medigap quotes using our instant online quote engine or ask for a free, no obligation consult.

PPO Advantage Plan

PPO Medicare plans come in two varieties. There are regional PPO Medicare Advantage plans and local PPO Advantage plans.

  • PPO plans have a list of network (PPO) approved doctors and other providers you may use
  • You may use a provider that is not on the list but you will have more out ot pocket (penalty)
  • You do not need a referral to see a specialist, but if you use a non-par specialist your costs will be higher
  • Medicare Part A and Part B services are provided by your PPO plan but you will generally pay more for these services than you would with original Medicare and a Medigap plan
  • Many Medicare Advantage plans charge a premium IN ADDITION TO your regular Medicare Part B premium
  • Advantage plans can charge deductibles and coinsurance that is higher than original Medicare

 

Bob Vineyard, President of Georgia Medicare Plans, has decided to specialize in GA Medigap plans. We believe the flexibility and overall VALUE of original Medicare and a Medicare supplement plan are superior to the Advantage plans currently on the market. We invite you to compare GA Medigap quotes using our instant online quote engine or ask for a free, no obligation consult.

SNP Medicare Advantage Plan

SNP Medicare plans are Special Needs Plans for a certain class of Medicare beneficiary. Many who qualify for SNP’s are considered dual eligible (qualify for Medicare and Medicaid).

Special Needs Patients usually meet the following criteria.

  • Qualify for both Medicare and Medicaid (dual eligibility)
  • Have a specific qualifying debilitating illness such as chronic diabetes or COPD
  • Live in a nursing home or require at home nursing care

Special Needs Plans provide “focused care” for those with specific health needs. Their care is more tailored to the condition than is possible with traditional Medicare. Some SNP’s have benefits not included in original Medicare. These benefits may include prescription drugs, hearing and vision benefits and more.

Special Needs Plans allow you to enroll or disenroll at any time during the year.

SNP’s are great options for those who qualify. We are not approved by CMS to offer Special Needs Plans but will refer you to someone who can assist.

 

#SNPMedicareAdvantage

Piedmont Wellstar Medicare Advantage 2016

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The popular Piedmont Wellstar Medicare Advantage HMO plan will not be available in 2016. Existing members have received their non-renewal notice and now begins the task of finding new coverage.old lady adjusting glasses computer

Piedmont Wellstar tried to put a smiley face on their announcement ……….

“While PWHP has chosen to exit the Medicare Advantage program, largely because of premium deficiencies, our success … can be measured against the ‘triple aim’ health care goals of improving the patient experience and quality of care, while reducing the trend in health care cost,” the statement read. “To this end, PWHP has been successful as demonstrated by our members’ satisfaction, our quality of care and our ability to keep healthcare cost trends per member flat for the past 18 months.” – Marietta Daily Journal

“Premium deficiencies” is just another way of saying the plans provided way too many benefits which resulted in attracting sicker patients that led to losses.

Premium deficiencies and success do not belong in the same sentence.

Roughly 12,000 existing members will lose their P-W coverage as of 12/31/15.

Post summary

  • Piedmont Wellstar discontinued for 2016
  • Pick a new Advantage plan and you may have to change doctors and hospitals
  • Original Medicare, keep your doctor
  • Original Medicare and a supplement plan
  • Sleep well at night knowing you made the right choice

If you are tired of having coverage dropped and want to pick your own doctors and hospitals, perhaps it is time to return to original Medicare and a supplement plan.

Medicare does not have doctor or hospital networks.

Medicare will never cancel your coverage.

When you select the right Medigap plan you can keep it for life.

Medicare shop and compare

 

Piedmont Wellstar – What Next?

The 2016 Medicare open enrollment kicks off October 15 and ends on December 7. Current members can pick from any of the following.

  • Enroll in another Medicare Advantage plan
  • Return to original Medicare
  • Return to original Medicare and enroll in a Medicare supplement plan

The first two options are straight forward. Keep in mind that changing to a new Advantage plan means checking to make sure your doctors and hospitals are in the new network and cross-referencing your medications with the drug formulary.

It also means being prepared to repeat this process every 1 – 3 years in the future. grandma shaking head

One couple losing Piedmont Wellstar coverage had 13 doctors between them and numerous medications. After spending more than an hour researching options they still did not have a workable solution.

Who wants to go through that again?

Medicare Advantage plans are great when you are healthy but the numbers change when your health goes south.

 

Return to Original Medicare

Some Piedmont Wellstar orphans will simply go with original Medicare, maybe a drug plan, and take their chances.

While that approach does guarantee access to any doctor or hospital it may not be the best financial option. Medicare alone is an open ended plan that pays 80% of covered Part B charges while you pay the remaining 20%.

Open ended means you pay the 20% portion until you are well again, dead, or run out of money.

Two of those three options are not good.

 

Medicare Plus Supplement

All of my clients want the freedom to pick their own doctors, find a drug plan that fits their needs and don’t want the hassle of trying to change plans every year.

With original Medicare and a supplement you can sleep well at night.sleep well at night

Almost every conversation I have with prospective clients begins with them saying “I don’t want to change my doctor”. I can certainly understand that position. When you have health issues you want a doctor you know and one that knows you. Conditions that require frequent checkups to make sure that mole on your skin is not changing or making sure your medications are controlling your sugar levels give you comfort when dealing with someone you like and trust.

If you are in good health you can purchase any Medigap plan you want from any carrier. This opens up a wide range of plan choices and premium savings that are not otherwise available.

But if you are in poor health you are not frozen out of the Medicare supplement market. Instead your choices will be limited to a handful of plans and high prices. The most common “guaranteed issue” option is Medigap plan F.

It is also the most expensive.

A female, age 67, non-tobacco user in zip code 30060 will see plan F premiums from popular carriers at $154 (Aetna), $159 (Omaha), $180 (AARP) and $183 (BCBSGA).

That same female that can qualify medically will have the ability to enroll in a Medigap plan N without the network hassle. Plan N premiums for this lady start at $89 and the out of pocket maximum is normally less than $500 vs the cap on the Piedmont Wellstar plan at $4000.

Plan N is very similar to Medicare Advantage plans except without

  • provider networks
  • annual notice of change
  • pronounced increase in your out of pocket cost sharing
  • threat of cancellation (when you pick the right carrier)
  • insurance carrier bureaucracy

Georgia Medicare Plans has rates for over 170 different Medigap plans available throughout the state. You can also review instant online quotes, comparing multiple plans side by side. The image below links to our quote engine. This is a secure, private site. Your information is never sold.

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This might be the right time to replace your cancelled Piedmont Wellstar plan and return to the security of original Medicare and a quality Medicare supplement plan.

 

 

#PiedmontWellstar #MedicareAdvantage #MedicareSupplement #GeorgiaMedicarePlans

How to Find the Right Medicare Plan

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Scroll down for UPDATE

 

Do you want to know the secret of how to find the right Medicare plan when you turn 65? Medicare supplement plan F or a $0 premium Medicare Advantage plan? What’s the big deal if you can change plans every year? How can the insurance company offer a free Medicare plan? What’s the catch? Is there something the insurance agent isn’t telling me? Why not cut out the middle man (the agent) and just buy direct?which-medigap-is-best2

If you are turning 65 and aging in to Medicare you have more questions than answers. And there are probably questions you never thought to ask ………. until it is too late.

If you already decided on a Medigap plan you might want to check the rate. There are more than 170 Medicare supplement different plans in Georgia but most don’t illustrate their premiums online.

Shop and compare GA Medigap quotes.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

Find the RIGHT Medicare Plan

Georgia has more than 170 different Medicare supplement insurance plans, more than 45 drug plans and about 25 different Medicare Advantage plans. How can you possibly find what you need to know and make the right decision the first time?

Compared to Medicare Part D, and Advantage plans, picking a Medigap plan is a piece of cake. That doesn’t mean it is easy, just easier.

If you have the right information.

The information a consumer really needs is not available to the public.

You won’t find it on Medicare.gov.

You won’t find it on the Georgia Dept of Insurance site.

You won’t find it on public forums.

You won’t find it on sites with “instant Medigap quotes” ……………. including mine.

Where will you find the information you need to make an informed decision and choose the right Medicare plan for your needs and budget.

Pick up the phone and call. I will answer all your questions and give you rates by phone and email a comparison.

Call 404 907 0925.

 

You can also start the discussion by email or securing a Medigap quote through my site.

 

 

Susan is turning 65 and wants a Medicare supplement plan

A short time ago, Susan visited my site.

Twice.

Medicare changesThe first time she entered her information for a quote she was a non-smoker. The second time she was a smoker.

Both times she listed a valid email address.

Both times she gave a bogus phone number.

I know because I called and the number was disconnected.

No problem. I know some people don’t like to talk on the phone.

Since I didn’t have a valid phone number I sent an email asking if she used tobacco or not. Rates are higher for tobacco users with most carriers, so I wanted to give her accurate rates.

I also have access to over 170 different plans and rates. Most of them are not shown online anywhere.

They are not on Medicare.gov

They are not illustrated on carrier sites.

They do not appear on agent sites, including mine.

This isn’t a plot. Some carriers don’t want their rates made public.

Susan responded to my email. Here is what she had to say.

The first entry was a mistake.  I didn’t realize that non-tobacco was checked.  I am still a tobacco (cigarette) user but I have cut my smoking down to about 5 cigarettes or less a day, using e-cigarettes. (Comment: for rating purposes she will be considered a smoker with MOST carriers)

I don’t really have any questions.  I won’t be 65 until November so I have plenty of time to search online for the best rates. (Comment: Yes, she does have time. Will she find the best rates online? No).

I’ll probably go with Plan G if the difference in a year’s premiums between it and Plan F is more than $147, and I’m sure it will be. (Comment: Plan N might be an even better choice)

The last thing I want is a long, drawn out conversation on the phone with someone attempting to explain things I always know. (Comment: That’s the last thing I want too).

I’m just simply looking for the best rates for Plan G or Plan F.  I’m familiar with Medicare and how it works.  My husband is already on Medicare.  I much prefer to search online and actually read article than have someone attempt to explain anything to me.  I will let you know if I do have further questions.

My response was simply to provide the best rates based on her data and wish her well.

I don’t know if she believes she can game the system and get a non-tobacco rate or not. That is not my concern since I closed her file.

I did quote non-tobacco rates, using a carrier that does not assess tobacco loads if you buy when you first turn 65 and go on Part B. The rates are accurate and lower than anything Susan can find online.

Based on her age, tobacco use and zip code she will probably pay at least $150 more per year than she needs to and that is just the first year. The carrier with the next best tobacco rate has a history of dealing higher than normal rate increases.

Medicare.gov is a great place to go if you want information on ALL the Advantage plans in your area, and ALL the Part D drug plans. In fact, I tell prospective clients to buy Advantage plans or drug plans by calling 1-800-MEDICARE.

But if they want accurate information on all the available Medigap plans in Georgia, they should talk to me. I have more information on Medicare supplement insurance carriers than Medicare does. And if you ever have a question AFTER you buy, give me a call.

You will get me or my voice mail.

You will never hear “Press 1 for English”.

 

UPDATE

A few weeks later I got another email from Susan, our online shopper that didn’t want to talk to anyone. She told me the best rates she could find for plan G were $115 from Aetna and $118 through Omaha. She wanted to know if these rates were good.

She completely ignored my email from a week earlier giving her a rate of $106 for plan G.

My response, “The rates are good. Pick the one you want”.

 

 

Medicare supplement or Medicare Advantage?

Which is the right Medicare plan for you?

That is something you need to decide once you have the facts and understand your options. My job is to educate you so that you have enough information to make the right choice based on your needs and budget.

I won’t tell you what to buy.

You will never be pressured into buying anything at any time.find medicare information

There is no charge for my advice. The carriers pay me when I assist you in finding the right plan based on your needs and budget.

Give me 5 minutes on the phone and decide if I can be helpful or not. That’s all I ask of anyone.

If you like what you hear, great. If not, no problem. Move on and I will close your file.

The rates and plans I show you are identical in every way to those you can get direct from carriers.

The difference is, you get the benefit of my 40 years in the health insurance business at no additional charge.

Call the carrier or 1-800-INSURANCE and you never know who will answer the phone or how much they know about Medicare.

Before you go any further, I suggest the following links.

The Secret Life of Medicare Advantage Plans

Don’t Buy a Medicare Drug Plan

Those two posts should answer many of your questions and put you on the track to finding the RIGHT Medicare plan.

You might also want to shop and compare GA Medigap quotes. Click the image below for an instant quote. No gimmicks.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

 

#Turning65Medicare #ChoosingTheRightMedicarePlan  #MedicareSupplementInsurance

The Secret Life of Medicare Advantage Plans

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Medicare Advantage plans have a secret life. The carrier won’t tell you. Neither will the agent. If you knew these secrets you secret life of walter mittymight change your mind about signing up for one. Consider this. Why does if Medicare Advantage plans are so great, why does Medicare give you an escape clause? Why do some agents that sell you on the idea of an Advantage plan tell you to throw away your red, white and blue Medicare card? Why do agents push Medicare Advantage plans so much? Is there something you need to know that they aren’t telling? Do these Advantage plans really have a secret life? And how can they push these Free Medicare Plans? What’s the catch? Why is turning 65 so difficult when it comes to Medicare?

Have you already decided that original Medicare and a Medicare supplement plan are right for you? We have access to over 170 different Medigap plans from more than 30 carriers. We will freely share information on any plan you want, no obligation.

Want to take a peek at GA Medigap quotes? Click the image below.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

Post summary.

  • Turning 65 and signing up for Medicare. How?
  • How good are the free Medicare plans?
  • Why do most agents push $0 premium Advantage plans?
  • How do I get out of the Advantage plan when I realize I made a mistake?
  • Why can’t I keep my doctor?

Medicare Advantage plans secret life

Wanda is turning 65 in a few weeks and is totally confused. Should she stay on her husband’s group insurance plan or go in Medicare? Original Medicare or a Medicare Advantage plan? And what’s up with this free Medicare plan a lot of her friends have?

lady pensiveWanda was referred to me by a dear friend. The two of them had lunch earlier in the day and Wanda told Emily (our mutual friend) that she was turning 65 in a few days and totally confused.

Emily mentioned my name and then emailed me with a copy to Wanda. I called Wanda shortly after responding to the email.

Wanda’s husband works for a big company in Atlanta. They have a very good group health plan through his employer. The plan covers Wanda, her husband and their youngest child. The company pays all but $600/month for health insurance, vision and dental coverage.

Wanda has not signed up for Medicare.

After a short phone conversation I told Wanda what she needed to do.

  • Go online today and sign up for Medicare Part A only.
  • Keep the group plan, at least for now.
  • Do not sign up (yet) for Medicare Part B, Part D or a supplement plan.
  • Throw away all the literature that has been coming in for the last few months.
  • Stop talking to your friends.
  • Forget about the free Medicare plans agents are pushing
  • Call me when your situation changes and you are ready to go on Medicare Part B

That’s it. No sales pitch. No arm twisting. Just an honest appraisal of the situation and advice.

But what about the secret life of Medicare plans?

Read on.

 

Why do your friends sign up for a “free” Medicare plan?

Well, it’s pretty simple. They signed up for a “free” plan because somebody talked them into it.huckster

If someone tells you something is free, don’t you get suspicious? Have you ever received anything of value that was truly free? Isn’t there always a catch?

Here is the first catch.

Medicare does not allow an agent to tell you their Advantage plan is free. If they do say that, they are violating the CMS marketing rules.

$0 premium Medicare plans are not free.

  • You still have to pay your Medicare Part B premium.
  • You are not allowed to use your red, white and blue Medicare card.
  • Every time you see a doctor, have lab work, a scan, are admitted to the hospital you have to pay.
  • If you want to keep your out of pocket costs to a minimum you must use THEIR doctors and hospitals.
  • Your out of pocket costs could easily exceed $500 per month under an Advantage plan.
  • And if these plans are so great, why does Medicare allow you to dis-enroll?

 

One Other Thing in the Secret Life of Advantage Plans.

Medicare does not allow agents to tell you about ALL the plans in your area, only the ones they can sell and earn a commission.

The agent can legally only show you one carrier at a time. If you want information on another carrier Medicare rules say they must wait 48 hours before telling you about the other plan. Apparently the folks at Medicare think you are not smart enough to consider more than one plan at a time.

How silly is that?

So why do agents and carriers push Advantage plans?

They are profitable.

An agent that sells you an Advantage plan makes twice as much commission as they would by offering you a Medicare supplement plan. That alone is pretty good incentive but to make it even better they are paid their full years commission the month after your coverage goes into effect.

You sign up in October. Your coverage goes into effect in January. In February your agent collects $400.

Even on that $0 premium plan.

 

No Premium? How Can That Be?

As if that isn’t enough, some agents will tell you how great the Advantage plan is because you only have to pay $250 per day for the first 7 days you are in the hospital.

Then they will tell you that you need a plan to cover that contingency and will proceed to sell you an extra plan for only $38 per month.

The agent pockets 60% of your monthly premium as their compensation. That’s another $274 in commission over the next 12 months.

Next they might ask if cancer runs in your family, or if you know anyone that had cancer.

The good news is your $0 premium plan pays 80% of the cost of your chemotherapy treatment.

The bad new is, you pay the remaining 20%. The worse news is, some chemotherapy treatments run in excess of $3,000 each.

Medicare pays $2400. You pay $600.

For each treatment.

You really should consider a cancer plan to cover that out of pocket cost. For only $40 per month you can have a plan that covers the costs of chemo and pays you a flat $1,000 for your initial diagnosis.

The agent pockets 60% of that premium as well.

Now your $0 premium plan is costing you $78 per month but at least you have your out of pocket costs for a hospital stay covered as well as your chemotherapy.

And the agent made $962.

You should have called me.

For about the same monthly premium you pay nothing for a hospital stay and your chemo is only $147.

Not per treatment but for the entire year!

And you no longer need to pay for a hospital inpatient plan or a cancer plan.

How sweet is that?

 

Your Medicare Escape Clause

If your Medicare Advantage plan is so great, why does Medicare give you an escape provision?escape hatch

That’s right. If you enroll in a Medicare Advantage plan and later discover you don’t like it you can quit the plan (Medicare calls it dis-enrolling) and go back to original Medicare. It’s called a Trial Right.

You also have an annual dis-enrollment period that runs from January 1 through February 14.

All these ways to QUIT a Medicare Advantage plan. Is it any wonder why it is called the secret life of Advantage plans?

Of course if your agent told you to throw away your red, white and blue Medicare card you will need to get Medicare to send you a new one.

Don’t expect the agent that sold you the Advantage plan, and the hospital plan and the cancer plan to tell you that you can always change to original Medicare if you don’t like the Advantage. Your Trial Right is just another part of the secret life of Advantage plans.

As long as we are talking about secrets, here are some things you need to know.

  • Your Trial Right period doesn’t last forever
  • Your Trial Right may entitle you to purchase ANY Medigap plan.
  • Or you may be limited to only certain plans pre-selected by Medicare
  • Unless you exercise your trial right correctly you may have to go without drug coverage until the next open enrollment
  • Your annual dis-enrollment period comes with some barbs.

When you first turn 65, if you reject original Medicare for an Advantage plan that may be the only time you could enroll in a Medicare supplement plan without restriction.

Choose wisely.

The Medicare Advantage Convenience Factor

Mangled Care

Did you ever wonder how the insurance company can offer you coverage and not charge a premium but still pay the agent over $400 for enrolling you?

It’s a secret.

mangled careManaged care has been part of the fabric of health insurance for 30 years now but too often managed care becomes mangled care. When an insurance company bureaucrat that knows nothing about you or your medical condition decides on your care the outcome is mangled care.

When you reject original Medicare the government pays the insurance carrier a monthly fee to cover some of your expenses. The less THEY pay for your care the more money they get to keep.

When you are diagnosed with cancer ….

  • THEY get to pick your doctor
  • THEY pick your hospital
  • THEY decide which treatment is best for you based on the lowest cost to THEM
  • THEY pay 80% of your chemotherapy (the same amount Medicare pays) and you pay the remaining 20%

Original Medicare does not have mangled care. With original Medicare and your red, white and blue card

  • YOU pick your doctor
  • YOU pick your hospital
  • YOU and your doctor decide which treatment is best for you

Original Medicare pays 80% of the cost of your chemo but with your supplement plan your share is $0 if you have plan F or $183 for the entire year if you have plan G.

One other thing about Advantage plans.

Depending on where you live there may be anywhere from 3 to a dozen Advantage plans available.

  • But your agent can only tell you about the plans he or she is approved to sell.
  • If you want to find out about ALL the plans you have to talk to more agents
  • Each agents can only tell you about the plans they are approved to sell
  • Your agent is not allowed to compare one plan vs. the other

Agents will never tell you this (but I will), you can find out about ALL the plans in your area by calling Medicare. That’s part of the secret life of Medicare Advantage plans. Agents can’t tell you about all the plans in your area.

 

Would you like to see rates on Medicare supplement plans?

We have access to over 240 different plans in Georgia.

We can discuss the benefits and rates of every plan.

You can see plans online and get instant GA Medigap Quotes by following this link.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

If you call us we will offer rate reports and side by side benefit comparisons for any plan offered in Georgia.

We charge nothing for our advice. You get the benefit of my 40 years in the industry at no cost.

I will answer all your questions. Offer advice and let you decide which plan meets your needs and budget.

No risk.

No pressure.

No tricks.

No secret life.

No agenda.

Give us a call. We want to help.

 

#MedicareAdvantagePlans #MedicareTrialRight #MedicareSupplementPlan #Medigap

Do I Need an Insurance Agent?

Do I need an insurance agent to buy a Medicare supplement plan? How much extra will I pay to buy through a broker? Do insurance agents offer the same plans that I can get direct from a carrier? Don’t most insurance agents push the plans that pay them the highest commission? confused senior medicare

It doesn’t matter if you are turning 65 and going on Medicare for the first time or you have been in the Medicare system for a few years. Most people still don’t really understand how Medicare works and how it applies to them.

You have questions. We have answers.

Shopping for Medicare coverage? With more than 230 different Medicare supplement plans in Georgia, how do you find the one that is right for you? Click and compare rates and plans from GA Medigap quotes

Have you ever seen a Medigap rate report like this?

Everyone I talk to will get a report that is customized to reflect the plan or plans where they have an interest.

If the agent that is trying to SELL you on buying from him or her isn’t offering information like this, what else are they keeping from you?

 

Should I use an insurance agent when buying a Medicare supplement plan?

This question comes up from time to time but I suspect it is often considered but rarely asked. When it happens to me it usually comes in the form of “How much do you charge for your advice?”.

Perhaps I should consider it an affront, but I don’t. I do wonder if they ask their home and auto insurance agent same question. Similarly, when people go online do they ask them how much more they have to pay for buying a plan from an 800 number agent?

My response is always the same.

bob on fbMedicare supplement plans you buy through me are the exact same plan at the same rate as those you would buy direct from the carrier. The only difference is, when you buy from me you get the advantage of my 40 years of experience at no additional charge. When you have a question you can call or email.

When you call you get me or my voice mail. You will never hear “Press 1 for English”. You won’t be routed through a bunch of prompts. I return calls within 2 business days and often the same day. If I can’t answer your question I will tell you so and will get back to you within 24 hours with the answer you need.

Call a carrier and you talk to whoever answers the phone that day, if you get a live person. More often than not you get voice mail. You have no idea who will call you back or when. You don’t know if they have worked for the carrier for years or just started last week.

Did I mention you pay the same premium for the same plan when you buy from an insurance agent?

 

Where can I see all the Medigap plans?

You can’t.

Some of is because most agents don’t have a quote engine on their site where you can see Medicare rates instantly. Something like this.

Georgia Medigap plans & Prices

Georgia Medigap plans & Prices

 

Even if you find a quote engine you will probably only see a few plans. That’s the way it is on my site. The people who designed and maintain the quote engine only have permission from a few carriers to illustrate their rates.

If you found a site with 230+ Medigap plans and up to 50 different carriers it would probably overwhelm you.

Insurance agents act as filters, showing you the good and bad and providing insight into not only current rates but carrier history.

 

Bill and Brenda went Medicare shopping

Last year Brenda visited my site a few times, reviewed available plans and rates, but was not available when I called. I left a message but never heard back.

I only call once. If I get voice mail, I leave a message. That’s it. I don’t bug people to death. I don’t chase them down.

Meanwhile Bill and Brenda received several automated emails from me. Each one had information about Medicare in general as well as specific information on Medigap, Medicare Advantage and Part D.happy couple

After a few weeks had gone by Bill emailed me. They were both turning 65 and going on Medicare in a few months and they wanted me to come to their home one evening to discuss options.

Only one problem.

I don’t make house calls and I rarely conduct business after normal office hours, but I did agree to call them at a designated time and day.

 

How Much Can You Really Save?

We talked for perhaps 40 minutes or so. I walked them through the Medicare process and answered all their questions. I agreed to send them information by email so they could study their options in their time frame.

Brenda had already discussed Medicare with her friends and was convinced they needed to buy plan F from AARP/United Healthcare. If they needed plan F they could save $500 per year with a different carrier but the real savings would come by switching to plan G and save over $1000 per year.

The savings didn’t stop there.

Brenda was taking a “prescription” dose of Niacin as part of her cholesterol medication regiment. When I ran their drug report it turns out she was prescribed an OTC version. Her pharmacist was pulling the medication off the shelf, slapping a label on it and charging over $100 per fill for a 30 day supply. She was paying over $1200 per year on her high deductible plan.

I looked on Amazon for the same strength, slow release Niacin.

$17 for 175 tablets.

She could get a years supply for around $35 vs. $1200 from her druggist.

I suggested she ask her doc about the OTC version from Amazon. She did and he blessed the change.

She changed drug stores shortly after that. Probably should have changed docs too but that was up to her.

The point of this is, a few phone calls and emails with an insurance agent (that would be me) resulted in a savings of over $2,000 per year by using an agent. Had she followed the advice of her friends that decision would have cost her a lot of money over the next few years.

 

Do you need an insurance agent?

Not really.

Anyone can do this but very few insurance agents take the time to educate their clients the way I do.

In September of this year I will be going on Medicare and I am pretty sure I will take my own advice. The same advice I give others.

You need adequate coverage to protect you against the cost of health CARE.

You don’t need to spend all your money on insurance.

You don’t need as much coverage as you think you do and can certainly do better than buying what your friends have. Unless they bought it through Georgia Medicare Plans.

Shop and compare now.

Your information is NEVER sold.

 

 

#MedicareSupplementInsurance #InsuranceAgent #GAMedigapQuotes