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No one wants to talk about this but...

My friend Valerie offers her experience and advice

Speaking of Medicare

For those of you who have crossed the Medicare threshold and are ready to pick your supplemental healthcare plan may ‘The Force’ be with you because you’re going to need all the help you can get navigating the minefield of  Medicare.

I happened to be retiring at the end of 2019 which coincided with applying for Medicare with coverage starting January 1st when my employer’s coverage would end. We used an independent agent help us with our application process and review which plans would suit my husband and me.   In hindsight, I should not have counted on someone else to provide me a solid and informed overview and spent the time to educate myself. When the agent showed up with applications for only one insurance carrier, with just two options (Medicare Advantage and “regular” Medicare) I knew I might be unaware of the bigger picture.

I’ll skip the ugly details and we ended up in a Medicare Advantage plan; with no premiums or co-pays.  You select doctors and medical groups within the network for your health providers.  Sadly, I was going to lose doctors I had been with for at least thirty years!

Resigned to search for a new provider I was confident there are other doctors that can provide what I needed, and I went to the plan website to find our new primary doctor within a medical group. I had no familiarity with any of these groups and did what any other undecided person does, consult Yelp.

*Some advice for making big, important decisions like a Medicare plan, don’t consult Yelp. 

After selecting a primary care doctor, I learned doctor was no longer accepting new patients (the provider websites are not up to date and it is up to the doctors to remove themselves as providers! Crazy right?) and the agent submitted the applications anyway since I could select a primary care doctor later. However, within a few days, I received a letter from our new Medicare Advantage provider that said I ONE WEEK to select another provider, not the original information of one month.  From here I started educating myself from YouTube videos in order to make the changes I needed. Do yourself a favor and watch as many as you can until you feel comfortable with the process.

Now that I was educated, I instructed the agent to change us from the Medicare Advantage plan to standard Medicare with a Medicare Part G Supplemental plan which will include monthly premiums, and most importantly we get to keep our family doctors.

I have to say that this whole experience has reinforced what I knew all along; you must be your own advocate.  Don’t relinquish your choices to anyone, unless you trust that person with your life.   Educate yourself about anything and everything that’s important to you, such as your healthcare; and do it as far in advance as possible. For some, spending a little more on healthcare premiums may be the best choice for you for others a Medicare Advantage plan with no premiums is better for their financial security. There are choices and it’s best to find what works for you. Happy Health in 2020.

What to ask yourself:

Do you want to retain your existing doctors and understand

a) they must accept Medicare patients

b) they must accept a Supplement Plan with an insurance provider you will choose

c) you understand you will pay Medicare Part B and no Medicare Part A (dependent on work experience)

c) you understand a Supplement Plan is additional cost to you through a selected insurance provider.

d) you understand if you select a Medicare Advantage plan there are no additional out of pocket cost however your required cost of Medicare Part B will be collected by Medicare to cover the cost of your Advantage Plan.

Let us know if you have any other advice.

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