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

5 Medicare Open Enrollment Tips You Must Know

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Medicare open enrollment begins October 15 and ends at midnight December 7. There are at least 5 things you must know to avoid financial disaster.  You can be turning 65 and enrolling for the first time or have seen this movie before. Some people make the same mistakes over and over again without realizing the problem.

The next open enrollment is October 15, 2018.

If you think you already have all the answers, don’t read this post. If you believe Medicare open enrollment is for everyone you will probably learn something.

Did you know some parts of Georgia only have a few Medicare Advantage options but over 230 different Medicare supplement plans are available? Rather than “one-size-fits-all” you might be better suited to finding a plan that meets your needs and budget.

 

Post summary.

  • What you need before entering the open enrollment arena
  • Why you should never buy a drug plan from a stranger
  • Open enrollment isn’t for everyone
  • You may be denied a Medigap plan
  • Why you don’t want to auto-renew your drug plan or Advantage plan

Let the games begin!

Medicare Advantage – Oops I Made a Mistake

Medicare Open Enrollment Tips and Secrets

The first thing you need to know, Medicare open enrollment isn’t for everyone. Medigap plans never participate in open enrollment. No matter how well your drug plan served you this year it can turn into a nightmare next year.Medicare Open Enrollment

Be prepared!

Don’t buy a drug plan from a stranger. Don’t auto-renew anything.

Medigap plans are owned by you. A solid Medicare supplement plan will suit many well for years to come. Advantage plans are rented from year to year. The actual cost of the plan cannot be determined until you need it. By then it may be too late to change.

When in doubt, get advice. Even if you are confident, get advice. Don’t be afraid to ask for directions, even when you don’t think you are lost.

 

If You Don’t Know Where You Are Going You Will Wind Up Somewhere Else

Before enrolling in Medicare at age 65 for the first time, or planning your next move during Medicare open enrollment, there are things you need to do first.

  • Make a list of all doctors including name, address, phone
  • List all area hospitals, especially the ones you have used
  • Make a list of all medications including dosage, refills, prescribing doctor and pharmacy
  • Be aware of the donut hole and look for ways to avoid that trap
  • Make use of generics and off plan purchases
  • Look for FDA approved generics and ask your doctor before making a change
  • If renewing, get your drug list ID and password date from your last drug plan finder
  • If renewing, study your ANOC for changes
  • Use Medicare.gov for reviewing Advantage and drug plan options
  • Avoid using Medicare.gov for drug plan comparisons prior to October 25
  • Medicare.gov and the GA DOI site is essentially useless when comparing Medicare supplement options
  • Most Medigap quote engines only list a handful of options and rarely have plans with the best value
  • Many quoting sites will sell your information to numerous agents; some don’t provide instant quotes

Never put anything on auto-renew unless you like unpleasant surprises.

 

It’s Like Deja Vu All Over Again

It may seem like it, but just because you have been through open enrollment before doesn’t mean you got it right. In fact, most people get it wrong. Sometimes they eventually figure it out, sometimes not.

Putting your coverage on autopilot is one of the biggest mistakes people make.

Medicare Open EnrollmentAdvantage plans change every year even if the premium doesn’t. Doctors and hospitals leave the network. Copay’s and deductibles change. Most of the plans have increased the maximum out of pocket allowed by Medicare.

When your health changes your out of pocket charges can exceed $500 per month PLUS MEDICATION. At that point it is probably too late to change to a Medigap plan.

Drug plans change more than anything. It doesn’t matter if you have a stand alone Part D or a drug plan built into your Advantage plan. Your medication cost is almost guaranteed to increase over the current year.

Prescription drugs consume 25 – 30% of total annual health care costs. Your biggest savings can come from picking the right drug coverage.

Don’t buy a drug plan from an agent. Most will only show you the plans that pay them a commission. Good for them. Bad for you.

Don’t buy a drug plan from a carrier. They will only tell you what THEIR plan covers.

Don’t rely on a drug finder report for next year that is calculated before the end of October. It is rarely correct. Always keep a copy of the report including your drug list ID and password date. You may have to challenge the carrier if the formulary changes or ask Medicare for an SEP to move to another drug plan mid-year.

 

When You Come To A Fork In The Road, Take It

Some people are better off with original Medicare and a Medigap plan. Rarely will anyone be financially safe with Medicare alone.

Others are just fine with an Advantage plan.

Fork-In-The-Road

One is not inherently better than the other, but one is a better choice for your future needs.

Don’t let anyone tell you one plan is better than the other. If they try to sell you something, walk away. You don’t need them.

Shameless plug follows.

Bob Vineyard and Georgia Medicare Plans won’t sell you anything, but he will help you to buy the plan that fits your needs and budget. No hard sell. We educate our clients, listen more than we talk, ask questions, offer advice and then let you decide.

People hate to be sold but they love to buy.

We don’t sell anything.

We are shamelessly biased in favor of Medigap plans. That’s what I bought. Ask most agents what they will buy when they are on Medicare. If they are honest most will say they will buy a Medigap plan.

If you want an Advantage plan, call Scott. I will give you his number and a recommendation. Just ask me.

We are happy to help you buy the plan that fits your needs and budget but only when you are ready. Sometimes we will even tell you to keep the plan you have.

 

I Knew I Was Going To Take The Wrong Train, So I Left Early

If you have a Medigap plan and want to change, you may be denied.

If you have an Advantage plan, and want to change to a Medigap plan, you may be denied.

Medigap does not have an open enrollment.

wrong trainThere are only a few ways to get a Medigap plan without medical underwriting. One is to sign up when you turn 65 and enroll in Medicare for the first time. For many, that will be their ONLY CHANCE to purchase a Medigap plan.

Another is to successfully pass medical underwriting.

In some situations you may have a guaranteed right to purchase a Medigap plan but you may not get the plan you want or can afford.

Medicare open enrollment is only for those with drug plans and Advantage plans. Everyone else that wants a Medicare supplement plan may have to settle for something less.

I talk to people every day that say they are healthy but will never qualify for a Medigap plan. I can tell you in 3 minutes or less if you can qualify.

Don’t waste your time chasing something you can’t get.

 

I Never Said Most Of The Things I Said

Some agents will tell you anything because they think that is what you want to hear. Your friends are great but don’t buy what they have because what they have may not be right for them and it may not be right for you either.

“All my friends have AARP Plan F and it pays for everything”.

Yes, it does. But all plan F’s pay for everything and most will charge you a lot less than AARP.lily_tomlin_ernestine

“I have a Medicare plan and it doesn’t cost me a dime”.

Just because you don’t pay a premium doesn’t mean your coverage is free. Advantage plans are great until you use them then you may find you can’t really afford them.

$0 premium is not the same as $o cost.

Which works better for you? $0 premium or $0 copay and $0 deductible?

We specialize in Medicare supplement plans. We have rates for over 170 different plans and will freely share information by phone or email. No one will come to your house. You don’t come to see us. Most people like it like that.

If you really want an Advantage plan, we won’t try and talk you out of it. That’s not our job. We have an agent that handles those things for us. He is very good and you can take what he says to the bank.

You can get an instant online quote on our site. Your information is never sold. The quote engine only has about 30 plans. If you want to know all your options just ask. We have nothing to hide. We will even give you rates from plans we don’t sell.

We want to make your life simple so you can get back to enjoying retirement and the grand kids.

No smoke.

No mirrors.

Just solid advice.

We want to earn your business. Is that too much to ask?

Medicare open enrollment isn’t for everyone but we can make it a lot easier.

Medicare Open Enrollment

 

 

#MedicareOpenEnrollment #MedicareSupplement #MedicareAdvantage #GeorgiaMedicarePlans

Medicare Open Enrollment 2015

The Medicare open enrollment 2015 edition opens October 15 and closes December 7. If you are turning 65 you will be making best medicare supplement plan Fdecisions along with 48 million retirees looking to change their plans. Significant Medicare changes are expected in 2016 so plan accordingly. Medicare premiums and deductibles will rise next year and so will Medicare supplement premiums, especially for Medigap plan F. Medicare Part D drug plan costs will move higher as the donut hole gradually closes before 2020 when it disappears completely.

Also, Medigap plan F will be retired in 2020. The result will be even higher prices for plan F than you see now. Don’t be roped into buying a plan that will soon be cost prohibitive.

Instant online GA Medigap quotes. Shop and compare up to 30 plans side by side.

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Expect fewer Medicare Advantage plans, especially in rural Georgia. More PPO plans will go away and be replaced by HMO’s. Advantage premiums probably won’t change much but look for higher copay’s, higher deductibles and more plans will move to $6700 out of pocket maximum.

Keep in mind the MOOP (maximum out of pocket) only applies to IN NETWORK APPROVED claims (excluding drug costs).

Post summary:

  • What you need for open enrollment
  • Turning 65, new to Medicare, open enrollment not for you other than Part D
  • Losing employer retiree plan? Check out your options
  • Shopping online? We can guide you through the maze
  • Upcoming surgery? Medicare Advantage probably the wrong choice

 

Medicare Open Enrollment

All Medicare drug plans and Advantage plans run on a calendar year basis. Your current plan may or may not renew but whether it renews or not you need to be prepared for the Medicare open enrollment in 2015.

Here are a few pointers if you are new to Medicare or have been to this rodeo before.

  • Update your list of medications and dosages
  • Make a list of your doctors including name and address
  • Evaluate your health. Is it better or worse than last year?
  • Update your health care budget
  • Consider what you pay every month in premiums AND your out of pocket health care costs
  • Any planned surgeries or tests? You may save money having them done this year ….. or next.

More on planned surgeries coming up below in this post.

 

If You Are Turning 65

Turning 65? If you are not receiving Social Security, you need to sign up for Medicare A and possibly B. The easiest way is to go online using this link to Social Security.

happy birthday 65I did this in June. It took about 10 minutes. Three days later I received my Medicare letter and about 10 days after that my Medicare cards.

If you will be covered by an employer group plan you may not need Part B. However, you may need Medicare Part D if your current plan is not considered creditable.

If you have Medicare Part A, have been covered under an employer group plan and you want to enroll in Medicare Part B only you will need to complete forms CMS40B and CMSR297 then mail to Social Security or take it to their office for processing.

If you do not sign up for Part A when you turn 65 you may encounter delays and penalties in the future.

 

Losing Retiree Health Insurance

Many large companies including IBM, GE, UGA are terminating existing retiree health insurance and employees are being told to talk with consultants like Towers Watson and One Exchange.

If you are part of a group losing your retiree health plan there are things you need to know.

  • You may be required to purchase at least SOME coverage through the “exchange” to receive HRA monies
  • Most exchanges only show you a small sampling of plans in your area
  • The advisers are encouraged to push plans that pay a higher commission, even if that choice is to your detriment
  • Most of the Medigap plans on the private exchange are over-priced
  • Many times you can preserve your HRA bonus by purchasing Part D only through the exchange

There is no charge to consult with Georgia-Medicare Plans. You can run quotes on our website through this link and we will also email information on the lowest priced Medigap plans in your area.

Medicare open enrollment is your chance to shop and compare.

 

Shopping for Medicare Supplement Plans

Instant online rates are available for about 30 different GA Medigap plans through our quote engine. You may find that helpful but the real savings may lie among the more than 170 different Medicare supplement plans in Georgia.confused senior medicare

Online quote engines are limited to half a dozen carriers. We have Medigap rates for over 30 different carriers.

Some carriers offer lower non-tobacco rates to tobacco users when you meet the criteria. A few carriers have household discounts of up to 7% but many times the savings are mostly smoke and mirrors.

It doesn’t matter if you are new to Medicare or feel you have been given bad advice in the past, we are ready to listen to your concerns. There is never any obligation to buy from us (although we do hope we are given a chance to earn your trust) nor is there a charge for our time.

We have the same plans and rates you can get direct from the carriers. The difference is you don’t have to press 1 for English and you benefit from our 40 years in the industry.

Use this Medicare open enrollment time wisely. Others talk, we listen

 

Planned Surgery and Medicare

If you anticipate having major surgery within the next 12 months or so, you need to make the right choice when turning 65.

It doesn’t matter if you are having a joint replaced or eye surgery. Enrolling in a $0 premium plan is probably not your best option. Most newly minted Medicare beneficiaries will be much better off with a $0 copay, $0 deductible plan than a $0 premium plan.

With a $0 premium plan the insurance carrier picks your doctor and hospital for you.

With a $0 premium plan you are responsible for the lions share of the cost of your care.

Once you pick a $0 premium plan you may never again have the option of buying a Medicare supplement plan. The annual Medicare open enrollment period only applies to drug plans and Advantage plans. Following your initial enrollment period you may only enroll in a Medigap plan by going through underwriting. This initial enrollment time may be your only chance to pick a Medicare supplement plan.

Choose wisely.

Medicare shop and compare

 

 

#MedicareOpenEnrollment #Turning65  #MedicareSupplementPlanF

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