Today is a guest post from a Medicare Guru, Joanne Giardini-Russell, who I was lucky enough to find. I was going to paraphrase, but nope, read the whole thing. Such huge and I mean HUGE mistakes are made when it’s time to sign up for Medicare. So yes, YOU DO NEED HELP. This is the reason why:
Medicare – 5 Tips for the Season
It’s that annual time of year! The ads come out, your neighbors, siblings and friends starting buzzing and asking “what plan do you have? Why do you pay anything – I pay nothing and love my plan… You should have…” Right?
Can I interrupt the fanfare for a few minutes? My company helps people make good Medicare decisions. That’s all we do. 100% Medicare. So, we watch you all making the same mistakes just about every hour on the hour!
This short article will point out a few of the most common problems that we see:
• That friend that pays nothing and tells you that you’re overpaying? They most likely
have an HMO style Medicare Advantage plan. They likely don’t know that if they step
out of their network, they may have zero coverage. If they have chemo or radiation
enter their world? They’ll pay 20% of a large number. If they need 18 sessions of PT?
They’ll pay $30 each time. If they want to go to Mayo Clinic? They can’t. Moral of the
story? Don’t listen to your friends.
• When agents and insurance companies tell you annually “you can change your plan next year if you don’t like this one”. Whoa, not so fast. Some people can, some people can’t.
There are two types of products to supplement your Medicare coverage. There is
Medigap and Medicare Advantage. Most people that learn about the two usually want
Medigap. But, there’s a catch – you have to medically qualify for the product at times.
SO, if you can pass the health underwriting in the year after “you don’t like your plan”
than, yes – welcome aboard the Medigap train!
• Pre-existing conditions. They DO exist after you turn age 65 and hit Medicare eligibility! We’re so ingrained with group insurance and generally no pre-existing condition worries but they DO reappear with Medicare. This relates to Medigap coverage. Here’s the
rule: When you are NEW to Medicare’s Part B (and I don’t care if you are starting Part B
at age 65, age 72, age 75, etc. – the important part is that you are starting it), you have a
six-month window of opportunity to purchase a Medigap contract with no health
questions asked of you. So, when you and I are speaking, and you tell me that you have
MS and get infusions that cost $30,000 twice a year and you are starting Medicare? We
are going to have a serious conversation and I’m doing everything in my power to steer
you to a Medigap contract.
• A giant hole in Medicare-Land: People not being introduced to nor understanding the
basic premise that “there are two products to pick from to become your supplement”.
The world tends to focus on Medicare Advantage (think corporate profits or agent
commission might have something to do with this? Yes, sarcasm injected). You need to
understand what you are buying and the limitations of your product if there are any.
Make an informed decision.
• If you buy a Medigap contract, you can go to any doctor or hospital in the country that you choose. As long as they take Medicare (the majority do), you may go. We find that
at age 65, most people want choice and control over their healthcare. With Medicare
Advantage you will have networks and restrictions.
So, those are some of the problems that we see over and over again. There are dozens of other issues (prescriptions, Cobra, Obamacare, etc.) but if you know these 5 things, you’ve become a Medicare genius amongst your friends and family.
We’ve designed our firm to help you navigate Medicare issues almost in the way that I raised my children. Not to insult anyone’s intelligence, but we assist you as if you were 5 years old.
Meaning we lay out the steps rather simply.
Example. You call for advice and the response is “please go get Part A and B of Medicare and come back to me and I’ll help with your product”. That is Greek to you, generally. Online? In person? Where? What do I need? Boomer Health Group will instead send you a video tutorial with the forms that you need to fill out. You’ll get guidance as to step A, then B, then C. You finish step A? Come back for step B. We’re not the folks assaulting your phone and mailbox with Medicare solicitations.
Best of luck navigating the season! We’re here to help as needed.
Boomer Health Group
248-871-7756
And a special thanks to Joanne at Boomer Health Group. Call her. Really.
“You Just Have to Laugh…..and get Prepared….”
Just an FYI, I shared this with several people.
1) Have a thirty something daughter on disability who just got approved for Medicare. In her state, VA, she has one, yes one, choice for a supplement and it’s only Supplement A which is fairly crappy coverage for $$. She was kind of forced to go onto an Advantage plan but did know enough to go for one that is a PPO.
2) Have a sixty year old brother on disability with private insurance for years. He just looked into switching onto a Medicare supplement during open enrollment only to find out he is not eligible even though he’s got part A. He can’t just sign up for part B and a supplement during open enrollment. He now has to wait until he turns 65.
Pays to check the rules with the experts!