News Pills For Weight Loss In California To Get Approved Mistakes to Avoid When Deciding On The Best Medicare Advantage Plan

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Mistakes to Avoid When Deciding On The Best Medicare Advantage Plan

It was a sad meeting… sitting with the couple at the kitchen table as tears streamed down their faces. She was very sick, losing weight rapidly from digestive problems, and with constant migraine headaches, and ended up feeling like she was the only way to stay pain free. To say they were nervous would be an understatement. The doctors associated with his Medicare Part C plan could not deal with the problem. They prescribed more drugs, which made her sick even worse. On top of his medical condition, Plan refused medical tests that might have discovered his problem. In October 2011, through their tears, they asked painfully, “What are our choices?

In this case, we decided together that it would be best for her to switch to a Medicare Supplement Plan (MediGap), which would allow her to go to a doctor or facility that accepts Medicare, and a ” Prescription Drug Plan Part D. .” It is important for him to be able to find the best, anywhere in the country. We chose “Additional Plan F” and a carrier can switch between a lower cost plan and a higher cost plan WITHOUT insurability (if in the future, he decides to keep the Supplemental Plan after completing his current healing puzzle).

Could he have avoided this problem in the first place? Perhaps. Here are two mistakes I’ve seen, along with solutions, to help you choose the right option for YOU:

MISTAKE #1: Who do you work with?

* Working with a “captive insurance agent” (directly employed by the carrier, often paid by W2, commission and/or bonus) or working with a ‘private practice agent’ (1099 contractor and carrier and lead signals) . The last word is very confusing to me. They are classified as private, but if they write an application with another carrier because it is a right for the recipient, their contract may be terminated. What is the buyer’s incentive not to share, if they lose their lead source?

** Another mistake is working with a vendor who is not licensed to market all types of Medicare health plans. They can sell ‘some’ MediGap supplemental plans’ without a certificate.

*** Go directly to the insurance carrier. If something goes awry, it’s good to have an advocate by your side especially someone you can see and live/work in your community.

EDIT #1:

* Choose an independent insurance agent who represents more than one insurance carrier. Why? Because private sellers know the pros and cons of ALL Plans you can provide this information so you can make the RIGHT choice. They receive payments from insurance carriers but have no loyalty to any company. Also watch out for carriers who force their ‘exclusive agents’ to sign an exclusive contract. I have seen this happen with ‘Dual Benefit Plans’ (Medicaid/Medicare Plans). Again, what about a ‘non-differentiated’ customer if the Plan is contractually bound to only one market?

** Choose a ‘Certified’ Medicare insurance agent who is able to market Part C, Part D and MediGap Plans. They have additional training and supervision.

*** When you go directly to the dealer, you are eliminating a competent person who will fix problems if they arise, giving you peace of mind throughout the process.

MISTAKE #2: Choosing a Health Benefit Plan You need to get the insurance company’s approval before the procedure/examination.

EXERCISE #2: Once the Plans have been compared, turn to ‘Summary of Results’. All carriers should produce these and they should be consistent and easy to compare.

MISTAKE #3: Ignore the ‘maximum out of pocket’ (MOOP) limit. All Health Benefit Plans are MOOPs, and there are many sales representatives who will help you choose your Plan. However, if a serious medical issue arises (cancer, organ transplant, long stay in a skilled nursing facility, etc.), there is a good chance that you will experience MOOP so you want to know that the very little. The reason: it’s considered a prescription drug for a chronic illness and against category ‘B’, not category ‘D’ prescription drugs and many Plans pay 80% of the drugs drugs Part B. Therefore, you will be on the hook for 20% and it is very expensive.

TIP #3: Compare, contrast, compare and choose a Plan with a cheaper MOOP.

MISTAKE #4: Choosing a Plan because the drug is cheaper. Many small insurance companies will assign you to their Plan with a minimum co-pay based on their medical record but have a smaller network of doctors/hospitals to choose from. The problem is, if a medical issue arises, you’re locked into a small network of doctors/hospitals until Medicare’s annual open enrollment.

TIP #4: If you are having trouble paying for drug costs and your income/assets are too low, you may be eligible for Supplemental Assistance through social security. A good insurance agent will bring this up and guide you or go to https://secure.ssa.gov/i1020/start. By getting help with your medical, you can choose the best Plan based on other options (their network size, coverage rules, physician/facility availability, additional benefits , etc.)

MISTAKE #5: Choosing a Plan because you want a PPO Plan that is not an HMO.

TIP #5: Many people are under the misconception that with a PPO Plan, they can go to any doctor/hospital of their choice. In fact, PPO Plans still have a network of doctors and facilities that you must live in to receive lower premiums. The main difference between a PPO and an HMO is that with a PPO, you don’t have to be ‘referred’ to see a specialist. With an HMO, you need to get a reference. To be able to choose ANY doctor/hospital in a country that accepts Medicare, you should consider a Medicare Supplement Plan (MediGap).

I have seen many mistakes and solutions when it comes to choosing Medicare Advantage Health Plans. Outside of California, there are many other types of Plans, which can be challenging.

What happened to my client, you ask? Since I always stay in touch with my customers, in June I was very happy to hear him call out the great news. With the same test denied by his previous Medicare Advantage plan, two doctors from a large Los Angeles medical group identified the problem. He slowly slipped through the water and was almost gone. With patients out quickly, they can heal the damaged area, replace the spinal fluid, and feel healthier, happier and better! Since he is now healthy, we will review his coverage during Medicare’s open enrollment period (October 15 – December 7, 2012) and determine whether he should remain on the supplement or switch. or to a Part C Health Benefit Plan.

As an insurance agent for many years, I have this information and more. Compassionately, our firm helps navigate the best options, explaining the pros/cons based on our clients’ individual needs and offering peace of mind. Plans change every year and your health/financial status may change, so it’s a good idea to compare every year. Finally, choose a good, local, independent insurance agent, be educated and stay informed!

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