Tips for Wily Medicare Veterans

“True wisdom is knowing what you don't know”  Confucius

"It ain't what you don't know that gets you in trouble.  It's what you know for sure...

that just ain't so."  Mark Twain

My little non-profit organization, ACS Clinical Pharmacy & Sociably Secure-NGO, produces a free educational program entitled, "The ABC's of Medicare Enrollment".  These programs are presented as a public service, nine months out of each year, at different public library locations throughout Monroe County, Michigan.

As a regular speaker and educator on the topic of Medicare rights and benefits... I am often asked for helpful hints and money saving insights involving all things Medicare.  I have gathered a few along the way that I call "Tips for Wily Medicare Veterans"... and am delighted to share them below:

*Tip for Wily Medicare Veterans:  the federal Medicare Program hires certified Medicare Educators to teach Medicare concepts at the county level.  One requirement of the job is that they  NOT be licensed insurance agents.  Because federal Medicare Educators have only limited knowledge about commercial Medicare insurance product… the advice that they offer about purchasing private insurance products can be uneducated, incomplete, flawed, and costly for you.  Talk to both a Medicare Educator and an Insurance Agent to get a balanced view of commercial Medicare insurance products before you buy.

*Tip for Wily Medicare Veterans:  make sure that the Medicare Advantage plan that you choose does business with the local hospital and the local medical community as part of its closed care network!

*Tip for Wily Medicare Veterans:  beware of Medicare Advantage policies that offer special lowered annual out of pocket limits by cost-shifting a large portion of the cost onto the annual cost of premiums.  For example:  a plan might reduce an annual out-of-pocket limit from $6700 down to $4500, a difference of $2200.  That $2200 is then added back on to the annual premium amount… resulting in ZERO net savings for the client.  Although this procedure might spread costs out over a longer period of time, making paying for them easier… the change rarely saves you any costs.  These plans should never be sold as cost saving plans, or less expensive plans.

*Tip for Wily Medicare Veterans:  buy your Medicare Supplement from an insurance agent who brokers for many different insurance companies that sell the plans.  Although the coverage for each plan (F Plan, N Plan, G Plan, etc.) from each company must be identical under federal law… prices from company to company will vary widely.  An insurance broker will offer a variety of prices from which to choose from an assortment of competing companies.

*Tip for Wily Medicare Veterans:  beware of Medicare Supplement policies that offer special lowered premiums for the first two policy years.  Premiums may skyrocket after the second year… and the enrollee would be required to health qualify to switch to a more affordable plan!  It is possible to be trapped in the more expensive plan by your own bad health.  Beware of this common bait and switch practice! 

*Tip for Wily Medicare Veterans:  the most important difference between the two Medicare supplement insurance products (Advantage and Medigap) is the out-of-pocket-cost to you.  How much must you pay, on top of insurance supplement premiums and Medicare Part B premiums… before coverage fully kicks in?

• Medicare Advantage Plans are high cost plans of $4500 to $6500 per year out-of-pocket.
• High Deductible Medigap Supplements are medium cost plans of up to $2100 per year out-of-pocket
•  Low Deductible Medigap Supplements are low cost plans that run as low as zero dollars per year out-of-pocket
•  Pick the supplement product with the lowest sum of annual premiums plus annual out-of-pocket costs!  Simple arithmetic.

*Tip for Wily Medicare Veterans:  because all Medigap Supplement Plans MUST BY LAW admit even the sickest enrollees into a plan during the initial seven month enrollment period; older plans tend to cover sicker, and riskier enrollee pools.  Older plans are often sicker plans that have higher premiums due to an accumulation of multiple past premium increases.  Be sure to shop with an independent insurance agent who brokers for several companies that offer several younger and healthier Medigap Supplement Plans… which should have lower premiums.  A good broker can offer two or three prices for the exact same Medigap plan, (F Plan, G Plan , N plan, etc.).

Know your rights under federal law before meeting with an insurance agent to discuss Medicare insurance supplement products:

Before You Meet With and Insurance Agent:

• The agent must make an appointment to meet with you in person.
• The agent must document the Medicare insurance products you wish to discuss.
• The agent cannot come to your home to discuss Medicare insurance products without your permission in advance.

During an Appointment an Insurance Agent MAY:

o       Give you printed insurance materials.

o       Tell you how to get Medicare plan information.

o       Talk about only the Medicare insurance products that you previously agreed to discuss.

o       Make a separate appointment to discuss any additional Medicare insurance products that you want to learn about.

o       Provide insurance enrollment forms, and collect completed forms.

o       Leave business cards for you to share with family and friends.

During an Appointment an Insurance Agent MAY NOT:

o       Discuss Medicare insurance products that you have not previously agreed to talk about.

o       Sell you any other insurance products not related to the discussion of Medicare insurance products; like life insurance.

o       Offer you cash inducements, or offer you items of value worth more than fifteen dollars.

o       Ask you for credit card or banking information, unless the information is used to pay for a purchased Medicare insurance product.

o       Use high pressure sales tactics like; “If you fail to act now, you might go without needed insurance protection.”

o       Ask for the names, addresses and telephone numbers of your friends and loved ones for the purpose of selling them insurance.

o       Pressure you to sign an enrollment form for a Medicare insurance product.

Insurance Agents who violate these good practices should be reported to Medicare by dialing toll-free:  1-800-MEDICARE

What you don't know about Medicare CAN hurt you... and WILL cost you money.  Learning the basics about Medicare rights and benefits only makes good sense.  How can you spot a Wily Medicare Veteran?  That's easy... they speak fluent Medicare.

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