Top Ten List – Most Incorrect Things I’ve Heard Regarding Medicare

Posted on May 17, 2012 by

As an independent agency that works in 40 states, we talk to people from all walks of life – all over the country, different backgrounds, experience levels with insurance, and different stages in the plan exploration process. From these conversations, I hear lots of interesting things. Most of it is correct – it’s amazing how much reading most people going on Medicare do and how much information they already know when we speak with them. However, I do hear some common misconceptions – this is our attempt to set those misconceptions straight for the mutual benefit of future people turning 65 or going on Medicare for the first time.

  1. “My friend says company XYZ “pays real well”. This is not entirely a myth. The company probably does pay well. The reality, however, is that all Medigap plans pay the same way – through the Medicare “Crossover” system. There are no appreciable differences in how fast, how much, etc. one company pays vs. another.
  2. “Medicare doesn’t cover any wellness care.”This used to be the case, but it is not anymore. Check it out: Does Medicare cover wellness care?
  3. “My doctor doesn’t take company XYZ Medigap plan.” If a doctor/hospital takes Medicare, they are required to take the standardized Medigap plans. They cannot pick and choose from among the Medigap companies.
  4. “Medicare Advantage plans are the same as Medigap plans.” This is certainly not true for many reasons. What are the Differences Between Medigap and Medicare Advantage?
  5. “I want to sign up for Part F or Plan A and Plan B.” This is a very honest, common mistake. Medicare has “Parts” (A, B, D); Medigap has “Plans” (A-N). Medigap Plans vs. Medicare Parts
  6. “I have Medicare A & B and coverage from my company but I want to get a Medicare Supplement to pay what they don’t pay.” This is simply not true. A Medigap plan will not even work well with an employer plan, if at all.
  7. “I have a Medicare Advantage plan and I need a Medigap to pay what it doesn’t pay.” Likewise, this is not true. In fact, you cannot have a Medigap and a Medicare Advantage. Medigap supplements Medicare; when you have a Medicare Advantage plan, Medicare is not your coverage.
  8. “My Medigap plan covers my prescription drugs.” This is only the case if you purchased your plan before 1994. The current plans do not include any prescription coverage.
  9. “My Plan F is better than XYZ Plan F.” The plans are completely standardized. What are the Differences in the Medigap plans?
  10. “This plan costs more so it must be better.” Unfortunately, no. It’s not that easy. I would never recommend paying “extra” for a plan because you recognize the name, heard it is good, etc. The plans are completely standardized. Save yourself the money in the beginning – get a lower cost plan. Coverage is the same.

If you have any questions about this information please contact us online at Medicare-Supplement.us or call us at 877.506.3378.

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Help! I’m Stuck in My Medicare Advantage Plan

Posted on May 15, 2012 by

Medicare Advantage plans are a privatized version of Medicare. These plans replace the government’s Medicare program and all of your benefits are provided through the private company. These plans are very different from actual Medicare Supplement plans (also called Medigap). One of the major things that differentiates the plans is that Medicare Advantage plans have certain period of the year that you can enroll/disenroll from the plans. Currently, that enrollment period is October 15-December 7 of each year. So what can you do about your Advantage plan during the year?

Unfortunately, there is not much that you can do if you want to get out of your Medicare Advantage plan during the year. There are some unique situations that qualify you for a SEP (Special Election Period), during which you can disenroll from your plan. I’ve listed a few of those below:

  • You move out of your plan’s service area. This will automatically disenroll you when you change your address. You can get a Medigap or a Medicare Advantage plan that is available in your new area.
  • You are institutionalized.
  • Your company stops giving service in your area or goes out of business.
  • You were misled by the company or the company didn’t do something they said they were going to do (has to be approved by Medicare).
  • You wish to switch to a 5-star Medicare Advantage plan that is available in your area.
  • There are a few other unique SEP situations. This list does not encompass all of them but does address some of the more common ones.

So unless one of these situations does apply to you, you are unfortunately “stuck” if you want to get out of your Advantage plan during the year – outside of the annual enrollment period.

I want to also address another way that you can get “stuck” in a Medicare Advantage plan. This is if you sign up for a plan and later wish to move back to Medicare with a Medicare Supplement plan. When you do so, you will have to qualify medically in order to get the supplement plan. If you have health problems, pre-existing conditions, etc. this can be very difficult to do.

While the Advantage plans do have low premiums, which are appealing, these plans do have some very significant downsides and pose the real threat of being “stuck” in a plan for a whole year – regardless of whether or not you are happy with it.

If you have questions about this or want to discuss further, you can visit us at Medicare-Supplement.US or call us at 877.506.3378.

 

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Who Are These People – The Differences Between Captive, Independent, and Sales Reps

Posted on May 14, 2012 by

While it may not seem ultimately important to you, who you talk to or use to sign up for a Medicare Supplement plan can be very important. Most people, for good reason, have no reason to understand the inner-workings or classifications of various positions with the insurance industry. However, it does have some impact on you. So what are the differences between the different types of agents?

The “captive” agent is just what it sounds like. This agent sells only for one company and is only authorized to “pitch” or sell for one company. Most companies that employ captive agents place some restrictions on them to prevent them from going out to get contracted with other insurance companies. Captive companies typically place the focus, in our experience, a little more on salesmanship. Agents go through a lot of sales training, teaching them how to explain the products and sell the products that their company sells.

Independent agents are not tied in to one particular insurance company. An independent agent can sell any company in the state that he is contracted to represent. There are a few companies who do not allow independent agents to sell their products at all – these are typically priced more highly (possibly they don’t want their plans compared with more moderately priced options?). An independent agent can enable you to compare all of the options in a centralized, unbiased place.

A sales rep is a representative that works specifically for an insurance company, usually in a call center. These are very similar to captive agents – they are just usually a little less personal because they work remotely in many cases.

If an agent you speak with is not presenting multiple companies/options to you, it is highly likely you are dealing with a captive agent or a sales rep. While you can certainly sign up for a plan through one of these agents, and they are licensed agents, you will not get hte opportunity to compare plans in an unbiased way. Also, and maybe more importantly, after you sign up for a plan, if you are dissatisfied or have questions, the captive agent or sales rep has ultimate loyalty to the company, whereas an independent agent can place your needs in a more prominent place, since they can simply enroll you in a different company.

Choosing a Medigap plan can be a very difficult or overwhelming thing to do. It is important to have someone who is knowledgeable to guide you along the way. This doesn’t cost you anything and is very helpful. Who you use is important too – and it is certainly important to understand whether they are presenting one of your options or have the ability to present all of the options.

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Help! My Medigap Rates Went Up

Posted on May 11, 2012 by

Like the price of eggs or haircuts, Medigap rates go up over time. Just five short years ago, Medigap rates were about 70-75% of what they are now. Where rates are $100/month now, they may have been $70-75/month just five years ago! That’s hard to believe but a sign of the times. Escalating Medigap rates are a classic example of people not realizing that they can do something about it, albeit small, and help themselves in the process.

Contrary to popular belief, you can change Medigap plans at any time (When Can You Change Medigap Plans?). So, we must start with the understanding of that premise. So many times, people get a rate increase notification, open it up, get frustrated but think there is nothing they can do about it until the “end-of-year enrollment period” (the mythological one, that doesn’t exist for Medigap plans). Then, by the end of the year, they have forgotten about the rate increase – they’ve been paying the higher rate for a few months and it has become the new “normal”. The same thing happens the next year!

Well, we are here to tell you that there’s a better way, and it’s really not that complicated. Whether it is us or someone else, there are many online resources that will give you comparative information/quotes for Medigap plans. When your rate goes up, you should always explore other options to see if there is one that would be more competitively priced for the same coverage. Coverage, as you probably know if you are already on Medicare, is Federally-standardized. Do you have a Plan F? It is the same coverage with a new company as it is with your current company. Same things with Plan G, N, etc. So, comparing “apples to apples” is very easy to do.

There can be as much as a $100/month variation in rates for the same Medigap coverage, within the same geographic area. Rates vary this much for many reasons, some of which are claims experiences, administrative costs, marketing costs, and also, some companies just target certain geographic areas, age, or plans more than others.

There is absolutely NO reason, especially if you are in relatively good health, to be paying more than the lowest possible rate for your Medigap plan.

The plans are standardized, can be used anywhere nationwide that takes Medicare, and pay claims through the same “crossover” system. So ultimately, the premium rate is the thing that matters and should be compared/considered.

To get more information on how to compare plans or to get a Medigap comparison by email, please click the previous link or call us at 877.506.3378.

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Medicare Supplement Application – Three Things Not to Do

Posted on May 10, 2012 by

Applying for a Medicare Supplement plan is a relatively easy thing to do. It should not be made more difficult than it is, particularly if you are in open enrollment or guaranteed issue, during which you cannot be made to disclose medical information or answer medical questions. There are, of course, a few things that you should make sure not to do when you are applying for a Medicare Supplement plan. These will prevent future rescission of your policy or problems with claims in the future when you most need your policy.

  1. This should go without saying, of course, but it needs to be said. Do not be dishonest on your Medicare Supplement application. Of course, you shouldn’t be dishonest other times either, but that’s up to your own morality! I’m just concerned with the negative consequences that being dishonest on a Medicare Supplement application could/would have on you, your insurance, your family, your agent, etc. In most cases, there are medical questions on the application. Sometimes, there are terms that are not familiar to you, because they are medical terms. If you do not know if one of the terms applies to you, usually an agent can answer the question for you. Or, you can contact your doctor to find out the answer.
  2. Do not leave required information out. Some information is “required” because of just that – it has to be received in order for a company to process your application. There are some fields on most applications that are not required. However, the bulk of the information, if it is on there, is required and is necessary to process your application. Not a week goes by when someone tells me that they want to pay by monthly bank draft but don’t want the company to have their bank information or they want to link their supplement policy with their Medicare but they don’t want to give the supplement company their Medicare number. While I can certainly appreciate the need for security and privacy, it is sometimes necessary to divulge to the company enough information to serve you properly.
  3. Do not apply for multiple Medicare Supplement plans. So many people think this is a good idea, but it is simply not. You should apply for one Medigap plan only. First off, you only need one, and you cannot have more than one. Also, an agent cannot sell you one if you do not intend to replace one that you have currently. They cannot knowingly sell you two Medigap plans – this is for your protection. Sometimes, people do this because they are afraid they will not get approved for the plan. However, you should apply for the first plan, wait to see if it gets approved, then apply for a second option if it does not get approved.

Completing a Medicare Supplement application is not as difficult as many other types of applications. It is advisable to use an agent or broker when you are completing one, so that they can clarify any questions and help you submit the application properly. Whether it is us or someone else, we recommend having an agent’s free services on your side. If you have questions or need help getting a Medicare Supplement plan lined up, please visit our website or call us at 877.506.3378.

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Qualifying for a Medigap Plan – When and How Do Medigap Companies Use Underwriting?

Posted on May 8, 2012 by

Qualifying for a Medigap plan is extremely easy to do when you are in a valid open enrollment (When Is the Medicare Open Enrollment Period?) or guaranteed issue period. During these time periods, there is no underwriting, no pre-existing condition restrictions or exclusions, and there is not a possibility of a company turning you down for coverage based on your health. However, when you are NOT in one of these enrollment periods, you do have to qualify medically by answering medical questions on the application. So what does that mean for you?

First of all, do not be intimidated by this. Although you do have to go through underwriting and many people have heard horror stories about medical underwriting and having to pay higher rates based on pre-existing conditions, this is not usually the case with Medigap plans. In almost all cases, Medigap plans are accept/decline applications, meaning that everyone pays the same rate. And, if you go through underwriting, you are either approved or declined based on your health.

The 2nd point to understand is that the underwriting varies greatly from company to company. Some companies use very limited underwriting, accepting nearly everyone who applies and is not currently in the hospital. Other companies are more stringent on underwriting. Obviously, it stands to reason that the more stringent a company is on underwriting, the more likely they are to be rate-stable over time (i.e. on average, if a company has healthier insureds, they will have fewer, or smaller, rate increases). Some of the major things that the more stringent companies ask about on Medigap applications are: insulin-dependent diabetes, cancer (usually last 2 or 5 years), heart attack/stroke (last 2 or 5 years), dementia/alzheimer’s, recent hospitalizations (number and frequency varies by company). This is certainly just a partial list – the things that companies ask about varies greatly and their “lookback” period can vary a good bit.

If you do have some pre-existing conditions and are comparing Medigap plans, it is highly advisable to use a broker who is familiar with the various underwriting practices of the different companies. This will allow you to compare the plans and have the experience and knowledge of a broker who can advise you on which companies would be your best options for getting approved.

Keep in mind, too, that when you are applying for an underwritten Medigap plan (this means when you are applying outside of an open enrollment or guaranteed issue period), you should allow a month for the underwriting process to be complete. It usually does not take nearly this long, but it can. So you want to allow enough time. Also, make sure you do not cancel your current coverage until you have confirmation from the agent or the company that the new plan is approved.

If you have a unique health situation or a question about whether you would qualify for a Medigap plan, please contact us online at Medigap plans or call us at 877.506.3378.

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The Prerequisites for Having a Medicare Supplement Plan

Posted on May 7, 2012 by

There are several significant prerequisites that must be in place before you are eligible for a Medicare Supplement plan. Take note to understand these and make sure you have them taken care of before you begin the processing of enrolling in a Medicare Supplement plan.

  1. First and foremost, you must live in the area in which the plan you are signing up for is offered. Medicare Supplements vary by zip code (different companies over plans in different areas). So, just because you have heard of someone in a different place having a plan, that does not necessarily mean that the plan is offered in your area. You must make sure you live in an area in which your plan is offered and available.
  2. Secondly, you must have both parts of Medicare – Part A and Part B. Typically, everyone gets Part A the first day of the month that you turn 65. You will receive a Medicare card 2-3 months in advance of this date, signifying that you are in Medicare’s records and that your Medicare benefits will be starting soon. If you are already receiving Social Security at that time, you will also be enrolled in Part B typically. So, you’ll receive a card and information in the mail signifying that you are in both parts of Medicare. If you, for some reason, do not wish to take Part B (usually if you are still covered through an employer or still working), you will have to contact Medicare to delay Part B. In order to be eligible for a Medicare Supplement, you MUST have both parts of Medicare – Part A and Part B – at the time the Medigap plan takes effect. This does not mean that you must wait to sign up for a Medigap until after your Medicare starts. Most companies give you 6 months prior to your 65th birthday in order to sign up for a plan. You should use this time to sign up for a plan, in order to have everything in place at the time your Medicare starts.

Getting a Medigap plan is an important part of going on Medicare. It is important to compare the plans, understand them, and choose wisely. If you want a comparative quote from Medicare-Supplement.us of available plan in your area, please contact us on our website or call us at 877.506.3378.

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Medicare Supplements – What Happens to Your Plan When You Move?

Posted on May 3, 2012 by

Medicare Supplements are Federally-standardized – that is, they are the same in each state (with a couple of exceptions). One of the most commonly-asked questions about Medicare Supplement plans is just what happens to the plans when you move. There are two different “sub-areas” within this question that determine the answer to the larger question of what happens to your Medigap plan when you move. The “sub-areas” are: in state moves (moves to another part of your current state) or out of state moves (moves from one state to another). We will touch on both of those situations below.

In-State Moves

Moving in-state is very straight-forward with Medicare Supplement plans. First and foremost, you do NOT have to change your Medicare Supplement when you move to another part of your state if you do not wish to do so. Companies are licensed by the state departments of insurance to do business statewide, so if a company that insures you currently operates where you live now, nothing will be different about that when you move to a different part of the same state. So, put simply, nothing happens to your Medicare supplement coverage when you move to a different part of the state.

However, it is important to understand that rates are always based on your zip code of residence. So when you move, it is possible that you will move to a less (or more) expensive area, in which instance your rates will adjust to the prevailing rates of your new zip code.

Also, with this in mind, one consideration you should remember is that you can re-evaluate your plan options based on your new zip code, and it is possible that there is another company/plan that has lower rates for your new zip code, allowing you to save hundreds or thousands of dollars a year in premiums for the same coverage. To find out quickly, visit Medicare Supplement rates by zip code.

Out of State Moves

Although out of state moves may seem more complex, in reality, they are not for the purposes of Medicare Supplement plans. Just like what is detailed above, when you move to a new state, you do NOT have to change Medicare Supplement plans. The plan are national plans and they are fully portable. If you travel, your coverage is the same at any doctor/hospital that takes Medicare nationwide, whether you are moving or just traveling temporarily.

Now, you must change your address with the insurance company in all cases. This, as mentioned above, may have an impact on your premium. However, you can keep the same plan and there are no “Guaranteed issue” provisions allowing you to change without medical underwriting. If you do elect to change, you do have to go through medical underwriting.

However, a change may be worth it, as depending on where you move from/to, rates can vary by as much as $100-200/month in different states – even for the exact same coverage. So it is definitely worth it, when you move, to evaluate the availability of different plan options.

If you want this information delivered by email, please fill out a request on our website at Medicare Supplement rates by email or call us at 877.506.3378.

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Who Sells Medicare Supplement Plans in ….?

Posted on May 2, 2012 by

Medicare Supplement plans are Federally-standardized plans that are sold by private insurance companies designed to fill in the “gaps” in traditional Medicare. These plans provide the same standardized coverage, from company to company. Here is the standardized coverage chart: Coverage chart. Although the coverage is the same with every company and in every state (with the exception of a couple of states), the companies that sell the plans in each state can vary greatly.

There are a couple of significant reasons that this varies from state to state. First of all, different companies target different geographic areas or operate only in certain areas of the country. This means that, whereas they may have plans for sale in each of the Midwestern states, they may not do plans at all in the Southeast. This occurs frequently. Second of all, all companies must be approved by the state departments of insurance before they can offer plans in a particular state. Sometimes, this can take some time or be held up for a variety of significant and insignificant reasons.

So, how do you find out who sells Medicare Supplement plans in your state? First and foremost, you should be able to obtain a list from the state department of insurance. Some of the states have this information online; however, it should be taken with a grain of salt. In our experience, possibly due to neglect or time constraints or the constantly-changing nature of insurance, this information is often out of date. Medicare also maintains a database of the companies that offer Medicare Supplements by zip code at www.medicare.gov. Again, this information can be very outdated or outright incorrect, but it is another resource.

If you are comparing plans to select a possible plan option for enrollment, I would highly recommend getting a list of available companies, with rates, company ratings, etc. from an independent agent, or broker. A broker is someone who sells Medicare Supplement plans to consumers as a representative of many different insurance companies. They can typically help you compare the histories of companies, as well as current rates for the companies that operate in your area.

This is a highly advisable way of comparing plans, simply because you can compare all of the options in a centralized, unbiased place. If you would like this information from us, you can reach us at 877.506.3378 or online at: Medicare-Supplement.US.

 

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