At Boomer Benefits, we have two teams of licensed agents who are Medicare experts. Our Sales Team is made up of plan advisers who help you initially evaluate all the coverage options. It’s their job to find you the insurance plan that is most suitable for you.
However, what sets us apart from all the competition is the service you get on the back end. We offer services that you won’t find anywhere else, and you can read examples below.
Here’s the deal:
Once you become a policyholder, you will be introduced to our Client Service Team. These ladies know more about Medicare than you can imagine. Their focus is to make everything easy for our existing clients after their policies are in force. Their purpose is that when issues or problems happen that are out of your control, you aren’t out there trying to figure out how to fix it on your own. They will coach you through and help get you connected with the right departments at either Medicare or your insurance carrier.
This team has extensive training in policyholder services, such as claim research and resolution, drug exceptions, Medicare appeals, annual rate shopping, and much more (which you can read about below). All of this goes far beyond just what you need to know to choose a plan. These are the ladies who will provide you expert help at claims time – when it really counts. They save our clients thousands of dollars each year by resolving claims issues, correcting mis-coded doctor bills, and helping clients lower their rates on Medigap plans.
While we can’t guarantee that you will always get the outcome you want or that every appeal will be won, we can promise that you won’t go through it alone.
Licensed and certified in Medicare-related insurance products, the Service Team stands ready to help you with any topic – they are truly Medicare experts. Let’s take a look at some of the entirely free, above-and-beyond services that this amazing team will provide to you.
Annual Part D Analysis
Most insurance agencies today will not assist with you Part D. This is because Part D takes a lot of time and the average agent commissions are very low – around $3/month. At the same time, back-end issues with Part D are very common and they eat up a lot of time for agents. So if a service agent spends even 1 hour per year helping you fix something, then they lose money on that drug plan. This makes it unprofitable for an insurance broker to help their clients with Part D, so most of them don’t.
We are the exception.
At Boomer Benefits, we always help our Medigap policyholders with their Part D needs because drug spending is a huge part of overall Medicare costs.
We want our clients in the plan with the lowest total out-of-pocket for their needs. Our agents go through over 40 hours of carrier certifications each year. This is so that they are qualified to help you review your Part D drug plan each fall during the annual election period for Part D.
Many times we find that your current policy is still the best one for you next year. Sometimes, however, we locate considerable savings, so it’s always worthwhile to have us check for you every fall.
Claims Research and Resolution
If you receive a bill for something that you are not sure you owe, simply contact our Client Service Team. You can fax or email us a copy of the bill. We will help you with the research. We’ll determine whether you truly owe this money or if the medical provider sent it to you in error.
It is unbelievably common for healthcare providers to send you a bill before they give the insurance company a chance to pay. Too many people pay these bills without thinking. Then the medical provider gets paid twice – once by you and once by your insurance people. We help you keep those dollars in your wallet.
Here’s another recent example: One of our client service team reached out to a client on a courtesy call just to check in and see if all was going well with his coverage. The client mentioned that he was just getting ready to pay a $1288 bill related to a hospital stay. He thought Medicare had denied the claim so he was just going to pay it.
Since the client has Plan F, we knew he definitely did not owe this bill. She contacted Medicare and learned that original bill had not been processed by Medicare at all. We helped his providers refile the claim properly, so that Medicare paid it’s share and then his supplement picked up the rest. Our client got to keep that $1288 in his pocket.
When we determine a carrier has rejected a claim, we provide expert guidance on filing appeals. We know that the thought of writing an appeal is stressful for you, so just ask for our help. We will coach you on crafting an appeal that is based on facts. Then we’ll help you submit this to the proper authority.
Over the years, our service team has been successful in helping our clients submit appeals. This has ultimately resulted in saving clients many thousands of dollars. We can’t guarantee you will always win an appeal, and you’ll have to do your part in producing evidence. However, we can guide you through the process so that you have the best chance possible, and so that you aren’t going through it alone.
Drug Exceptions and Other Part D Issues
Did you know that Medicare Part D plans are full of restrictions? They have quantity limits and prior authorizations which can delay your medications. The worst restriction is Step Therapy. This is where your plan refuses to fill your prescription until you have tried an alternative drug that is less expensive.
When this happens you need to file a drug exception to try to get the medication you need covered. Our team can walk you through exactly what to do. Sometimes this may involve a conference call to the carrier, which we can facilitate. Other times it might be a form that you need to file that we can provide.
Sometimes despite our best efforts, your exception is not approved. In that event, we can provide drug pricing that you can share that with your doctor. Physicians are often not aware that a medication they prescribe has a high copay on Part D. We’ll provide the pricing info to show your doctor. Perhaps he or she can find other solutions for you that are within your budget.
Another Part D problem that occasionally occurs is Medicare charging you a penalty for late enrollment into Part D when you actually had employer coverage since age 65 and don’t truly owe the penalty. This is always a pain because you have to file an appeal with Maximus, the federal government contractor who handles late penalties. We can provide you the necessary appeal form which is short and simple. We’ll also coach on what to say on the form and what documentation to attach so that you have the best chance of getting your late penalty corrected.
If you worked past age 65 and had creditable employer coverage to exempt you from the late enrollment penalty, be sure that you save the letter of creditable coverage from your former employer as that is key to getting the penalty overturned.
No matter which insurance company or Medicare product you choose, there will eventually be a rate increase for your policy. Most carriers in the Medigap market have a rate increase annually to keep current with healthcare inflation. When you receive a notice of rate increase, call our Client Service Team. We will research all the other insurance companies in your area offering the same policy for less.
We’ll also help you determine whether the savings is enough to warrant switching your insurance provider. Our agency works with more than 25 insurance companies. So if better rates are out there, we’ll be able to find them.
Regular check-in calls
Our Client Service Team reaches out to every single policyholder at least twice a year. We want to make sure that you are satisfied with your policy and to ask whether you have any issues you need help with. Many times we find that our clients do have questions and have just not had the time to call and ask. This kind of follow up will be invaluable to you when you have a busy life and don’t feel like doing research with your spare time.
Provider Directory Searches
Need to check a provider to see if he or she accepts Medicare or is in the network for your policy? Just give us a call – we can help you check. Moving to a new area and need to find a new doctor who accepts your coverage? We can do the legwork for you. What about durable medical equipment providers?
If you have your Medigap or Medicare Advantage policy through Boomer Benefits and you need assistance locating oxygen providers or insulin pump suppliers, etc… we are just a phone call away.
Medicare has deadlines for making changes. For example, if you wish to change your drug card, you can only do so during the annual election period from October 15th – December 7th. Since this falls during the holidays, it is easy to be distracted. Many people entirely miss their window each year. We send email reminders to our policyholders so that important windows like this are not missed.
Our Service Team is YOUR Team
After you enroll in a Medicare insurance plan, a member of our Client Service Team will reach out to you a few weeks after your effective date. We’ll confirm you received your policy and ID cards, answer any questions you have about using your new benefits. We’ll also give you direct contact numbers for our Client Service Team. This is where you’ll call to get immediate help on anything – from reordering a lost ID card all the way up to something complex like reconciling claims after a long hospital stay. Whatever you need – we’ll help you through it.
You can read more about why someone would want to work with us here.
Contact Boomer Benefits today and experience our incredible level of service. You can also read more about our agency’s client reviews here to learn more about our team of Medicare experts.