This is far and away the most common question we hear, and there's a lot of confusion and misinformation out there surrounding it. If you've watched just about any amount of TV, you've almost certainly seen a commercial with a famous ex-football player who once did a commercial wearing pantyhose. Yeah, that's right, we went there. These commercials give the impression that you can get everything under the sun for free if you just call a phone number and sign up. However, that's frequently not the case, and there's a lot that you need to know before making that call. Our goal is not to sell you a plan, but rather to help you understand your options so that you can make an informed choice.
The plans they are talking about are called Medicare Advantage plans, and they represent a completely different way to get your Medicare benefits from Original Medicare. They are sold and administered by private insurance companies instead of the government, and when you have one of these plans it's not that different from having private health insurance through an employer or other group. You typically have copays when you visit the doctor, in some cases you might have a deductible to meet, and there are networks of preferred providers for your plan. You might be able to go outside of your network at a higher cost, depending on what type of plan you choose. There may be an additional monthly premium for these plans in addition to your Medicare part B premium, or you might have a zero premium plan. There's lot of variety in plans offered by different companies, but one thing they all provide is a maximum annual out of pocket limit to protect you in the event of a major illness.
Because these plans are sold by private companies, they are able to offer benefits over and above what Medicare requires as a way to make the plan attractive to consumers. This is where the extra benefits come in. Most of them offer varying levels of vision, dental, and hearing coverage that Original Medicare doesn't provide, as well as various other benefits like the ones our football player spokesman talks about. However, these extra benefits are not guaranteed, and whether they are available to you depends heavily on where you live. Not all plans are offered in all areas.
If you want to know whether a Medicare Advantage plan is right for you, schedule an appointment with one of our professionals today and let us explain the ins and outs of how they work before you make a decision. Get your healthcare advice from an experienced professional, not a washed up football player or a voice in a call center. Oh, and about that pantyhose commercial? It's right here:
Like Medicare Advantage plans, Medicare supplements - or "Medigap" plans - are sold by private insurance companies to offset the 20% of healthcare costs that Medicare doesn't cover. Once you are on a supplement plan, you can't be canceled or have your premiums increased due to your health or claims history. But while the carrier can't increase premiums on an individual customer, what can happen (and does) is that the company can increase premiums on an entire class of customers on that plan based on statistical data, i.e., all men age 71 on Plan G. This typically happens every year, and the increases are often in the 3-5% range. This is normal, and as long as you are on the plan you will get these increases every year.
But sometimes the increases can be much larger due to an unexpectedly high amount of claims, similar to how everyone's home insurance might go up after a hurricane or other disaster strains your insurance company's financial position. Occasionally these rate increases might be in the 10-15% range, meaning that the company you're with might be charging a lot more for for the same plan than another company that's had smaller increases. In that situation, it makes sense to look at moving you over to another company, and because all supplement plans are standardized by the government your coverage won't change at all. We recommend conducting a plan review every 2 years to see if you can save money by changing supplement carriers. Sometimes, if we know that a company is about to roll out a big rate increase, we might proactively reach out to our clients who are with that company and schedule a plan review to try and get out in front of it. So we may very well reach out to you by phone and tell you that we need to take a look at your supplement.
However, there are some companies out there that have set up call centers that do nothing except robodial people and try to get them to change supplements over the phone. Insurance agents live on commission, so there is a financial incentive to unscrupulous agents to rewrite as many policies as possible, so beware of these types of calls. Convincing people to change supplements who don't really need to is called "churning," and while it's not illegal, it's certainly unethical. The best defense against these types of calls is to build a strong relationship with an agent you trust so that when the phone rings, you know exactly who you're talking to. If you've received one of these calls and have questions about it, we will be glad to answer your questions without trying to sell you anything.
No, you can change your Medicare supplement plan at any time, provided you meet the company's underwriting requirements. Medicare drug plans and Advantage plans have designated enrollment periods that you have to wait for, but supplements don't.
Only if you change your plan in addition to company. As long as you stay with the same plan (e.g., Plan G, Plan F, etc.) your benefits will remain identical regardless of who your carrier is. Congress standardized Medicare supplement plans in 1992, meaning that all insurance companies are required to offer the same coverage to make shopping plans easier and to prevent benefit structures from changing after someone is already enrolled in a plan. We usually put it like this... your supplement is like gasoline. You can go to any gas station you like, but it's still the same gasoline wherever you go. The only difference is what you pay.
No, we don't do that because those are useless. Assessing a client's needs requires personal attention, and there's no way we can give you a meaningful quote without understanding your personal and financial situation and coverage needs. That's why we offer easy online scheduling of appointments, and we can do it either by telephone or in-person. Anybody can spit out a generic quote that may or may not be appropriate, but it takes experience and personal interaction to quote you the right thing. Our clients understand this, and it's why they keep coming to us.