Medicare Advantage Archives | Georgia Medicare Plans

Do I Need an Insurance Agent?

Bob Vineyard · March 10, 2020 ·

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?

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 rates

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.

Medicare 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.

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.

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 #GAMedigapRates

Medicare Supplement or Advantage Age 65

Bob Vineyard · February 12, 2020 ·

You turn 65 and have to make a decision. Which is better? Medicare supplement or Advantage plans? Your initial enrollment in Medicare at age 65 can be frustrating and overwhelming. Did you get your FREE Medicare supplement quote yet?

Medicare supplement or Advantage? Which one costs less?
Are $0 premium Medicare Advantage plans a good deal?
Since I want to keep my own doctors, is Medicare supplement plan F right for me?
I am healthy and don’t see a doctor very often. It seems the $0 premium plans are good for me.
My spouse is always in the doctors office. Will they have to make a copay for every visit?

Can we talk? How will you pick the right plan that meets YOUR needs and YOUR budget for age 65 and beyond? Give me a call anytime.

Medicare Supplement or Advantage. Which plan costs less?

As long as you are healthy, the $0 premium Medicare Advantage plan is great. But you might want to set aside an extra $300 per month or more in a “rainy day” fund. When your health changes the Medicare Advantage plans are like a leaky bathtub that loses water faster than it comes in.

Medicare supplement or Advantage - Which is better?

What if you are not be able to come up with enough money to pay all your bills because you were sold an Advantage plan? Is this really what you want in your golden years?

Advantage plans are great for healthy people who never go to the doctor or hospital.

If you are living on a fixed income and need to budget your monthly expenses, a Medigap plan is usually the better choice. Your Medicare supplement plan F means you will never have to worry about paying for hospital or doctor bills.

$0 Premium Advantage Plan Seems Like a Good Deal

Yes it does seem like a good deal, and that is often the way it is sold by agents looking for an “easy” sale. When choosing Medicare supplement or Advantage, most agents will push the Advantage plans, especially the ones with $0 premium.

Do you know why?

An agent will earn 2x as much when you buy an Advantage plan vs. what they are paid to offer a Medigap plan.

And that $0 premium is so easy to pitch to someone on a fixed income . . .

What is better than free?

Medicare supplement or Advantage? Which is better for you and which is better for the agents bank account?

If you are struggling to pay your bills now what will happen when you need to see a doctor or have some tests and the Advantage plan requires you to come up with $500 or more to get the care you need?

A Medicare supplement plan makes it easy to stick to your budget without worrying about surprises.

Do You Like Your Doctors? Who Doesn’t?

If so, you probably want a Medicare supplement plan F or even G.

Almost every doctor, hospital, lab and clinic in the U.S. accepts Medicare patients. When you have a Medicare Advantage plan the insurance carrier tells you which doctors you can see.

Less than half the doctors in Georgia participate in ANY Medicare Advantage plan and the ones that do won’t participate in all plans. Your chances of finding a doctor that participates in your Advantage plan could be very slim.

Even if your doctors currently are “in network” for your Advantage plan they may drop out at any time. When that happens you find a new doctor.

If you don’t want to continually hunt for new doctors, then the answer to Medicare supplement or Advantage becomes an easy one.

Advantage Plans are Great if You Never Get Sick

But when your health changes, you will wish you had a Medicare supplement plan and by then it is probably too late to switch.

Advantage plans are “pay me later” plans. You pay little or nothing on a monthly basis but when you need to use your plan you pay and pay and pay. Oh sure, they have an out of pocket limit that in some cases is capped at $6700 (in 2018), but that is only for IN NETWORK expenses.

When you go out of network, and that is very easy to do, the out of pocket limit becomes meaningless.

Medicare supplement plans don’t have any networks so you pay the same regardless of the doctor, clinic or hospital you use. No penalties for seeing the wrong doctor or being admitted to the wrong hospital.

Medigap plans are great when you are on a shoestring budget.

So which is best for you? Medicare supplement or Advantage?

At Georgia Medicare Plans we explain all your options, including Medicare supplement or Advantage plans, and let you decide which one is best for your needs and your budget. We encourage you to get a free Medigap quote and review up to 40 different plans from a number of carriers. Click the banner above to shop and compare Medicare supplement plan costs.

#MedicareSupplementOrMedicareAdvantageAge65

Do All Doctors Take Medicare

Bob Vineyard · February 6, 2020 ·

Do all doctors take Medicare? The answer may surprise you. Which Medicare plans are widely accepted by Georgia doctors? Can my doctor refuse to take my Medicare plan? What happens then? How do I find physicians that take Medicare?

Do all Georgia Doctors take Medicare?

The short answer is no. A better answer is, most doctors DO accept Medicare patients. But some Georgia medical practices are not currently taking new Medicare patients or may have a waiting list for new patients.

This is especially true if you have a Medicare ADVANTAGE plan.

Finding a Medicare Doctor

Your challenge is even more diverse when you break it down by:

Doctors that take Medicare patients
Physicians that accept Medicare assignment
Doctors that do not participate in Medicare
Medical practices that participate in Medicare but not Medicare Advantage

The good news is, most doctors participate in Medicare and do treat Medicare patients. About 96% of physicians that do take Medicare also accept assignment of benefits. Doctors that may opt out of Medicare are usually in the mental health field and some chiropractic doctors.

Most Accept Original Medicare Patients

In Georgia about half the physicians accept Medicare Advantage patients and most of them will only participate in a few plans but not all. The number dwindles down further when you have an Advantage HMO plan.

Doctors can refuse to accept your Medicare Advantage plan if they are not in network. If that happens they are still required to file with original Medicare and then wait on Medicare to pay you. In these situations they are allowed to bill excess charges.

When you have an Advantage plan make sure you understand the rules and how your liability is determined.

Can My Doctor Refuse to Treat Medicare Patients

Medicare participation

Finding physicians that participate in Medicare is relatively easy. If you Google “doctors that take Medicare” you will find an array of choices including other search engines and referral services. My advice is to go direct to the source, Medicare.gov.

The Medicare physician finder is a useful tool for finding doctors, hospitals, DME suppliers and other medical facilities in your area that participate in original Medicare.

When you just use Google you will find doctors that

advertise locally on Google
are registered with referral services
are listed on Medicare plan sites
may be reviewed by Yelp or Angies List

While some of those sites may be useful the Medicare physician finder tool has been the most helpful for my clients.

Is Medicare Supplement Expensive?

Medicare supplement plans can be quite affordable and do not require network participation.

We NEVER Sell Your Information

https://www.gamedigaprates.com/

New to Georgia

Jean moved from California to Georgia a few months before turning 65. She had Kaiser in California but her plan offered only limited coverage in Georgia where she was considered a “visitor”. Jean had some medical conditions that required a specialist and she wanted freedom of choice when it comes to finding a doctor.

This meant saying no to Medicare Advantage plans with their limited doctor choice, high out of pocket and yearly changes in benefits.

Jean is living on a fixed income and needs a way to budget for her care. Original Medicare and a Medicare supplement plan was exactly what she needed.

No Selling Please

How do you find answers to your Medicare questions WITHOUT getting a SALES PITCH?

Everyone wants to talk. No one wants to listen and answer . . . until you BUY SOMETHING.

Something you don’t want, don’t need and can’t afford.

When Jean contact me she was living with local relatives and didn’t want a bunch of insurance sales people coming to see her. At Georgia Medicare Plans we believe in personal consultation in the privacy of your home. We know that many people do not feel comfortable having strangers in their home and several do not want to travel to see us. I employ a client centered focus and believe in respecting your “space”. That is why all of our clients receive information and advice by phone and email. There is never any pressure to make a decision and you move forward based on your time frame once you are comfortable you understand the Medicare system and can afford the coverage you want.

Find a Medicare Plan Accepted by GA Doctors

I spent several hours on the phone discussing her needs and looking at options. Then I emailed Jean information based on the benefits she needed and plans that fit her budget. I also provided her with details on Medicare Extra Help, a service that can reduce her out of pocket expenses for medication.

After reviewing all her options Jean selected Medicare supplement plan N from a carrier with a long history in covering Medicare clients. While most agents that talked with Jean pushed Medigap plan F she knew that plan was not going to fit her budget.

Blue Cross wanted $176 for plan F and United Health Care (AARP) even more at $180. Plan F with Continental (Aetna) had the lowest premium at $141. But that was still too much.

We talked about the differences in plan F, G and N and how each plan was more affordable due to cost sharing. Plan N coverer her Medicare Part A expenses at 100% but does require her to pay the Part B annual deductible + a $20 copay for doctor visits.

Jean’s premium for plan N was $86 from New Era insurance company. Even with the cost sharing she still cut her premium in half vs. most of the plan F plans.

Finding a Medicare physician

As mentioned above, the Medicare physician finder is the most reliable tool in your arsenal for finding doctors in your area. Once you find some doctors that fit your needs, make some phone calls.

Here is what you need to know.

Does the doctor participate in Medicare?
Are they taking new patients?
If you have an Advantage plan, are they CURRENTLY participating in that plans network?
Do they accept Medicare assignment?
Does the doctor require up front payment for Medicare patients?

Most doctors DO participate in Medicare and most take assignment. A medical practice that accepts Medicare assignment means

you never have to pay up front for Medicare covered services
you never have to file claim forms with Medicare
Medicare and your supplement plan will pay your doctor direct, not you
your doctor can never bill you for excess charges

Doctors that take Medicare is easy. But finding an affordable Medigap plan that meets your needs and budget can be difficult. In some parts of Georgia you may only have half a dozen Advantage plan choices and many of them may not include your doctor or hospital in their network.

However there are more than 170 Medicare supplement plans statewide. Finding a plan with our help is as simple as getting a personalized Medigap quote in the privacy of your home, picking up the phone or sending us an email.

Let us know how we can help.

#DoAllDoctorsTakeMedicare #GeorgiaMedicareDoctors #GAMedigapQuotes

Medicare Things You Don’t Know

Bob Vineyard · June 24, 2019 · Leave a Comment

Medicare things you don’t know (but wish you did). Questions you never asked because no one told you. And you will pay dearly if you are not prepared.

Medicare stuff you don't know — Medicare questions
you did not ask

There are things about Medicare that will trip you up when you least expect it. Not so much with Original Medicare, but there are things about Advantage plans no one mentioned. Medicare things you don’t know. Stuff like access to care and prior authorization.

Medicare Stuff About Advantage Plans

You may think you understand Advantage plans but my guess is there are things in this video that will shock you.

Almost everyone LOVES their Advantage plan until they have to use it. I get calls all year long from folks who say they can’t afford their Medicare plan and want a supplement.

Most GA Medicare Advantage premiums are $0. If they can’t afford their plan there’s a good chance they are incurring hundreds or even thousands of dollars out of pocket for claims.

Why Are Medicare Advantage Plans Popular?

I have a friend that has been bragging about his plan ever since he went on Medicare. He thought I was foolish for paying “all that money” every month for a Medigap plan.

A few years ago a cancer diagnosis was a shock. His provider had grant money to pay for his treatment so his out of pocket was minimal.

Now the Cancer is Back

Gary is learning things about Medicare he did not know. Such as prior authorization.

Before he can have a test ordered by his doctor, the carrier must APPROVE the test. It’s all about the money.

His oncologist wants him to have proton therapy but his plan will only pay for a less expensive protocol. Dollars drive many medical decisions when an insurance carrier controls your benefits.

Proton Therapy – It Helps Only a Few at a Wildly Extravagant Cost – MedPage Today

All he wants to do is get well but his Advantage plan is running interference. His carrier is interested in saving money. THEIR money. Not his.

It’s all about the dollars. Just another Medicare thing he did not know.

What is Prior Authorization?

According to the Kaiser Foundation “80 percent of Medicare Advantage enrollees are in plans that require prior authorization for at least one Medicare-covered service“.https://www.kff.org/medicare/issue-brief/prior-authorization-in-medicare-advantage-plans-how-often-is-it-used/

Prior authorization is more frequently imposed for HIGHER COST services.

Reading further . . .

A potentially overlooked consideration is access to covered services; specifically, how prior authorization may affect beneficiaries’ access to covered services.

Medicare Advantage plans can require enrollees to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service.

On the other hand, Original Medicare does not require prior authorization for most services.

There are probably many things about Medicare Advantage plans you did not know. Limited access to care because of prior authorization requirements is probably just one of them.

#MedicarePriorAuthorization #MedicareAdvantage #GAMedicareExpert

Why Are Medicare Advantage Plans Popular?

Bob Vineyard · May 16, 2019 · Leave a Comment

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