Hello,
We finally made it up to western NC for apple picking. And it’s a good thing we went last weekend, because the orchard we went to was out of apples to pick after last weekend! Amelia’s favorite part isn’t picking apples, it’s riding the cow train! Ansley got to ride along with Mallory too. The best part for me was gorging myself on apple cider doughnuts on the drive home! Amelia on the cow train below.
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Not only are apples in season, but Medicare planning is too. Healthcare planning is a vital spoke on our financial planning wheel that we review with our clients. If our health plan isn’t right, we may have unintended consequences. We’ll cover below some issues Medicare recipients sometimes have.
Medicare open enrollment began last Sunday and it will run until December 7th. Now is the time of year to make sure you have the best drug plan, Advantage plan, or supplement. Ansley with the pumpkins below.
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The Wall Street Journal ran an article about the “Big Mistakes People Make in Medicare.” One of the main issues outlined is people not understanding all the details with Medicare Advantage plans.
From the article, “Lothaire Bluteau, 66 years old, an actor who lives in West Hollywood, Calif., last year enrolled in one of the private plans known as Medicare Advantage. After he was diagnosed with prostate cancer last May, he discovered the specialists he wanted to see weren’t in his HMO’s limited network. He faced delays getting tests and treatment.”
The article continued, “He got a bigger shock when he tried to get access to more doctors by switching to traditional Medicare, run by the federal government. Bluteau worried about the steep out-of-pocket costs, so he tried to get a fill-in policy known as a Medigap plan that would cover many of those expenses. Yet health insurers said no because of his cancer diagnosis.”
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It’s important to remember that the first time we enroll in Medicare we are in a “guaranteed issue period.” What this means is we can select any type of Medicare Supplement (the government refers to a supplement as Medigap) or Advantage plan without answering any health questions.
A person can have a foot in the grave and if they are new to Medicare then the health insurance provider has to issue them any policy they want. When we elect to change our coverage in subsequent years, we will be asked health questions and like the situation with Bluteau above we may be turned down if we have a preexisting health condition.
As you age into Medicare, if you have health challenges it will be important to make a good decision the first time when you’re not required to answer health questions. From the article, “Advertisements for Medicare Advantage plans especially may promise rich bonus benefits such as dental and vision coverage, or even help paying for food, as well as generous financial terms. But consumer advocates said seniors should be mindful of the downsides.”
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Another common Medicare pitfall is, “People who sign up for Medicare Advantage plans: a lean menu of doctors and hospitals. The plans—particularly health maintenance organizations, or HMOs—can have limited networks that sometimes mean beneficiaries can’t go to the doctors or hospitals they want.”
If you are selecting an Advantage plan, it is important to ensure that the doctors you prefer to see accept that Advantage plan. If we have a supplement, then any doctor who accepts Medicare should accept our coverage.
One last quote from the article: “Medicare Advantage plans can sometimes delay or block access to care. A recent government investigation found some beneficiaries were denied services that should have been covered. You might need to get approval from the insurer before you get a surgery, or a referral from your primary-care doctor to see a specialist. You may also find that those nifty extra benefits touted in ads are extremely limited.”
It can be attractive to use an Advantage plan because of the low to no monthly cost, and that may work well when we are healthy. But when we see a healthcare provider, we need to understand who will generally pay copays and deductibles for our services. With a supplement we have a monthly cost and we can have a small deductible but the remaining 20% we are responsible for should be covered by a Plan G supplement.
If you’ve been prescribed a new medication, it may be a good idea to use this tool on the government’s site to input your drugs, dosages and quantities to find out if your drug plan is the most efficient plan. We recommend doing this exercise yearly.
If you’d like to take a deep dive into Medicare and how it works, please join us at the Tyger River branch of the Spartanburg Community College on Thursday November 2nd at 6:30. We’ll review the ABCDs of Medicare. You may register here.
Also, if you're curious what a Medicare supplement cost for you, give us a call and we can help you crunch the numbers.
Until next week,
David C. Treece,
Financial Planner
864.641.7955
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Clients Excel, LLC is an independent financial services firm that utilizes a variety of investment and insurance products. Investment advisory services offered only by duly registered individuals through Creative One Wealth. Creative One Wealth and Clients Excel, LLC are not affiliated companies. Neither the firm nor its agents or representatives may give tax or legal advice. Individuals should consult with a qualified tax professional for guidance before making any purchasing decisions. Clients Excel, LLC is not affiliated with or endorsed by the U.S. Government or any governmental agency. Clients Excel, LLC has a strategic partnership with tax professionals and attorneys who can provide tax and/or legal advice. |
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