Question 1

I’M TURNING 65 AND HAVE BEEN INUNDATED WITH MEDICARE PLAN INFORMATION FROM EVERY INSURANCE CO. ON GOD’S GREEN EARTH.  I WAS THE CEO’S SECRETARY FOR 30 YEARS.  I THINK I’M A PRETTY SMART PERSON.  BUT I AM SO CONFUSED NOW I DON’T KNOW WHETHER I’M COMING OR GOING.  HELP!

Accepted Answer

You would be surprised how often I hear this.  Not to worry, I can explain pretty easy the various parts of Medicare and the ones you need to pay particular attention to.  Original Medicare consists of parts A (Hospital, Skilled Nursing Care and Hospice) and B (Dr.’s, Labs, Physical Therapy, durable Medical Equipment, etc.).  The problem with A and B only is there are no caps on expenses.  Your minimalist choice should be a zero or low cost Medicare Advantage plan to at least put caps on expenses.  A deeper analysis of your history, needs and wants will provide additional direction for your plan choices, with Medicare Supplements being a higher coverage option that generally costs more.  Rx meds is another box that needs to be checked.

Question 2

I’M TURNING 65 AND WILL CONTINUE TO WORK.  MY WIFE IS 62 AND SHE IS ATTACHED TO MY EMPLOYER’S PLAN, SO I DON’T KNOW WHETHER TO TAKE MEDICARE NOW OR STAY ON MY WORK PLAN SO SHE CAN HAVE IT TOO.  ANY SUGGESTIONS?"

Accepted Answer

This is a pretty common dilemma couples face.  The correct answer depends on how healthy the wife is, how much of the cost the husband has to pay for her, whether or not his wife can maintain that coverage if the husband does go to Medicare, and what her options would be if she cannot stay on her husband’s plan, and what those would cost.  Pretty often the wife is relatively healthy but takes several brand name drugs which on the employer plan usually has unlimited co-pays.  Medicare Prescription coverage works much better with generic meds than brand, so if the wife can change meds that might solve the problem.  Many variations to this dilemma.

Question 3

WE’RE ON A PLAN G SUPPLEMENT BUT WE WERE TALKING TO OUR NEIGHBORS AND THEY ONLY PAY ABOUT $15 A MONTH FOR THEIR MEDICARE ADVANTAGE (MA) COVERAGE.  WHY ARE WE PAYING OVER A $150 A MONTH FOR OUR COVERAGE?

Accepted Answer

Well, how would your health and age compare to your neighbors?  Well, they are a little younger than us and they aren’t diabetic like we are.  Oh, I see.  Guess we better stay put.  Yes, probably!  There are Med Advantage plans for zero or low cost.  But some of them also have a $10,000 max OOP (out-of-pocket) for in-and-out-of network..  That obviously entails some risk.  The plan G costs way more, but the max OOP is $198 per year (2020) for literally all their medical expenses, period.

Question 4

I TURNED 65 8 MONTHS AGO AND STARTED OUT ON AN MA PLAN FOR $25 PER MONTH, BUT I’M FINDING THAT THE DOCTORS I WANT TO USE ARE NOT ON THAT PLAN’S NETWORK.  WHAT ARE MY OPTIONS? "

Accepted Answer

Actually, when you first go on an MA plan, whether at 65 or 75, you are guaranteed a return to a Medicare Supplement if you decide in the first 365 days that you would prefer it over the MA plan.  So, you would be eligible to switch.  MA plans are not bad plans, but they work better for healthy clients.  That said, lots of seniors cannot or will not afford what Medicare Supplements cost.  However, there are many ways to manage your health, no matter what type plan you have.  I’m an agent that can help you.  But only is you ask the questions.  My mind reading skills are near non-existent. 😊