Determining the best Medicare supplement plan for you is something far more simple than you might think. Many times when a person is new to Medicare, he or she feels overwhelmed by all the choices. They fear making a wrong decision. I can ease some of this fear by walking you through a series of simple questions you can ask yourself. This will help lead you to the best Medicare supplement plan that is most suitable for you.
First, let’s point out that Medicare supplements and Medicare Advantage plans work differently. In the beginning, you want to look at all of your options. So let’s start from there. Then we’ll use these questions to narrow down to the best Medicare supplement (or perhaps Medicare Advantage plan) for you.
Which Medicare plans are accepted by your doctor?
The best Medicare supplement or Medicare Advantage plan for you is one that allows you to see your favorite providers. If you are open to seeing new doctors, then your choices are wider because any plan you choose will have a good selection of health care providers. However, most people want to be able to see their current primary care doctor and/or specialists. A quick phone call to your doctor’s office can help you to narrow down the choices.
Here at Boomer Benefits, our licensed Medicare experts make these calls for anyone working with us to enroll in Medigap. In doing so, we’ve learned that it is important to speak with someone in the doctor’s billing department that understands networks. Ask the billing representative if the doctor accepts Original Medicare. If he does, then any traditional Medigap policy will enable you to continue seeing that doctor.
Next ask whether the doctor participates in any Medicare Advantage plans, and get a list of those plans. Now here’s the critical part: verify what you find out by checking each Medicare plan’s provider directory. Ensure that the directory shows that doctor in the network. Cross-referencing this information against the plan directory is critical.
All too often we have people contact our agency after they tried to do this on their own. Inevitably they find out too late that the person in the doctor’s office gave them incorrect information. That can happen pretty easily because most doctors see patients both over 65 on Medicare and also under 65 on group insurance. If you call in and simply say “ Does the doctor take Humana?” then you might be told yes because the doctor accepts Humana group insurance for people under 65. That does NOT mean he accepts Humana Medicare.
If you are at all uneasy about making an error, find a suitable broker like us to do this work for you. We know all the right questions to ask. Brokers do not charge fees, so you don’t have to worry that it will cost you anything. It’s the easiest way to be sure you are accurately identifying the best Medicare supplements for you.
What is your Risk Tolerance?
Our agency often works with clients who helped their aging parents through a few illnesses. Once such client, Sue, told me that her mother had battled lymphoma for many years and went through several rounds of chemotherapy. She was astonished at the size of the medical bills they received, and even further astonished to find that her mother’s Medicare supplement had covered every dime. Because of this, she knew she wanted the same kind of coverage. What Sue said was “If I am sick, I want to be able to concentrate on getting well. I don’t want to be worrying about how many bills are accumulating in my mailbox.”
So for this client, the natural choice was a Medicare supplement, which has very predictable benefits and covers comprehensively. A Medicare Advantage plan, on the other hand, requires cost-sharing from you. On many Medicare Advantage plans, the cost of chemotherapy is 20%. The plans do have an out of pocket maximum cap to protect you, but someone like Sue would worry about that during her treatment, so it’s not the right fit.
On the other hand, if you have some funds put away for a rainy day, you might enjoy the lower premiums that Medicare Advantage plans offer. Some people have a higher risk tolerance, and they are willing to shell out some copays and coinsurance in exchange for enjoying lower premiums. So ask yourself how much risk tolerance you have, and that should lead you toward one choice or another. This is the way we identify the best Medicare supplement plans for our own personal level of risk tolerance.
And that leads us to the third question, which is:
What is your budget for Medicare supplemental insurance?
Living on a fixed income is harder than most people think. You are still subject to inflation like everyone else, but the money you have coming in from Social Security and your investments has to last you for the rest of your life. Sometimes this single factor will make the decision for you.
For a person turning 65 in Texas, you might expect to pay around $150/month for a Medicare supplement. It varies by zip code, gender and age, but let’s use this number as an example. If your budget includes $1800/year for medical insurance, then a supplement provides great coverage. If spending $1800/year leaves you with very little for life’s other expenses, you might be more comfortable finding a Medicare Advantage plan with a $0 premium. Sure you’ll pay copays for doctors visits and hospital stays and other medical services, but if you spend less than $1800, you come out ahead.
So there you have the 3 main questions we walk our own clients through when helping them determine the best Medicare supplement for them. An insurance agency like Boomer Benefits can help you answer these questions and then find the best Medigap plans that meet your needs based on your answers.
If you enjoyed this blog post and learned from it, give us a try so that you can experience all the great back-end policy service that you’ll get. This includes free claims support and assistance with evaluating which Part D drug plan offers your medications. We also provide annual rate comparisons to ensure you stay with the most cost effective policy in your area.
The best Medicare supplement for you is out there! Get in touch with us for help finding it today.