Medicare Article
July 28, 2016 at 4:25 p.m.
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Totally irresponsible and inaccurate article about Medicare Advantage plans in the Times-Union last Friday. There are about 12 million people who have Advantage plans in the USA. I personally have 400 seniors on Advantage plans because of their choice to have one, most have been on such a plan through me for five to eight years. It stands to reason that if people were dissatisfied with such plans, they would not stay enrolled in them.
It is patently false to state that such plans will not cover nursing home, rehab or home health care, when Advantage plans are required by law to cover everything which Medicare Part A and Part B cover.
The rules for certification to market Advantage plans are very complex and specific toward protecting consumers. It is folly to suggest that seniors are “tricked” into certain Medicare plans. Consider that agents are not allowed to telephone anyone regarding Advantage plans. Period. Seniors call an agent after either seeing an ad or being referred to an agent by a satisfied Advantage client.
If the senior is at the point in time when they are new to Medicare, agents like myself inquire about health conditions when meeting with the senior, to impress upon them that if they have a serious medical condition such as diabetes, they need to strongly consider enrollment in a Medicare Supplement plan. The reason is, even though the premiums are substantial, if frequent hospital stays are anticipated, an insurer cannot ask medical history questions or decline to issue coverage to applicants when the person is new to Medicare. Whereas, later on, the insurer might well decline to enroll them in a Supplement if they had a serious medical condition. There is much to consider.
In reality, many seniors choose an Advantage plan because their out of pocket costs for monthly plan premiums are miniscule compared to the cost of a Medicare Supplement and a separate Part D drug card. Medicare supplement plans increase in cost as one grows older as well.
Advantage plans usually cover Part D drugs and have monthly premiums the same for all ages. Medicare Advantage plans pay claims instead of Medicare. An enrollee must have Medicare Part A and Part B in order to enroll in either a Medicare Supplement plan or a Medicare Advantage plan. The differences are discussed with seniors face to face so that a person can make their own choice as to what is best for them.
Medicare rules specifically protect seniors from losing coverage they had under a Medicare supplement plan also, in that, if dissatisfied with their first enrollment in an Advantage plan within the first 12 months after enrolling, they are guaranteed to be able to get their former Medicare Supplement plan back. In my experience, most people like the Advantage plans and stay with them for years.
Rick Wagner
Pierceton, via e-mail[[In-content Ad]]
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Totally irresponsible and inaccurate article about Medicare Advantage plans in the Times-Union last Friday. There are about 12 million people who have Advantage plans in the USA. I personally have 400 seniors on Advantage plans because of their choice to have one, most have been on such a plan through me for five to eight years. It stands to reason that if people were dissatisfied with such plans, they would not stay enrolled in them.
It is patently false to state that such plans will not cover nursing home, rehab or home health care, when Advantage plans are required by law to cover everything which Medicare Part A and Part B cover.
The rules for certification to market Advantage plans are very complex and specific toward protecting consumers. It is folly to suggest that seniors are “tricked” into certain Medicare plans. Consider that agents are not allowed to telephone anyone regarding Advantage plans. Period. Seniors call an agent after either seeing an ad or being referred to an agent by a satisfied Advantage client.
If the senior is at the point in time when they are new to Medicare, agents like myself inquire about health conditions when meeting with the senior, to impress upon them that if they have a serious medical condition such as diabetes, they need to strongly consider enrollment in a Medicare Supplement plan. The reason is, even though the premiums are substantial, if frequent hospital stays are anticipated, an insurer cannot ask medical history questions or decline to issue coverage to applicants when the person is new to Medicare. Whereas, later on, the insurer might well decline to enroll them in a Supplement if they had a serious medical condition. There is much to consider.
In reality, many seniors choose an Advantage plan because their out of pocket costs for monthly plan premiums are miniscule compared to the cost of a Medicare Supplement and a separate Part D drug card. Medicare supplement plans increase in cost as one grows older as well.
Advantage plans usually cover Part D drugs and have monthly premiums the same for all ages. Medicare Advantage plans pay claims instead of Medicare. An enrollee must have Medicare Part A and Part B in order to enroll in either a Medicare Supplement plan or a Medicare Advantage plan. The differences are discussed with seniors face to face so that a person can make their own choice as to what is best for them.
Medicare rules specifically protect seniors from losing coverage they had under a Medicare supplement plan also, in that, if dissatisfied with their first enrollment in an Advantage plan within the first 12 months after enrolling, they are guaranteed to be able to get their former Medicare Supplement plan back. In my experience, most people like the Advantage plans and stay with them for years.
Rick Wagner
Pierceton, via e-mail[[In-content Ad]]
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