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Hi there. Steve Thurmond here with Medigap Tennessee. Your source for Medicare Supplemental, Medicare Advantage, Prescription drug and Dental plans in Tennessee.
This video is for those of you born between 1946 and 1964. The most talked about generation in our country at the moment. This video is for you, baby boomers. You make up approximately 77 million people in this country and about 10,000 of you are turning 65 every day for the next 15 years or so. It’s being called the Silver Tsunami as the vast majority of you age into and take advantage of the Medicare benefits you’ve been paying into for the last 40+ years. I’m here to help you with some of the biggest insurance decisions you’ll be making as you retire and leave your employee coverage or move out of Obamacare and claim your Red, White and Blue medicare card.
This topic can be overwhelming and confusing, but we’re here to help take the frustration and worry out of it for you. So, you’re about to turn 65…congratulations, you made it to retirement! Here are a few things you need to be aware of as your birthday nears. Most individuals that opt into Medicare benefits receive their Red, White and Blue Medicare card in the mail about 3 months before their 65 birthday month. If you’re within that three month range and haven’t received your card yet, simply give Social Security a call and confirm that you’re enrolled into Medicare Parts A & B and that your Medicare card is on its way to your current address.
As you’re probably aware, Medicare parts A and B will cover 80% of your medical bills, but you are responsible for the other 20%. If you never get sick or land in the hospital for any reason, Medicare should be adequate coverage for most of your medical needs like annual exams and checkups. But, no one plans on getting sick or landing in the hospital, and I’m guessing you probably don’t have a crystal ball that tells the future, so you’ll want to pick up a Medigap plan to cover the other 20% that original Medicare doesn’t cover.
We purchase insurance for when things go wrong, not when they go right and when things go wrong, you want the security of knowing you have 100% coverage to take care of your medical bills. Medigap plans, also called Medicare Supplemental plans, take care of the other 20% that original medicare doesn’t cover.
These plans are offered by private insurance companies and there are 10 different plans to choose from. Not all companies offer all 10 plans, but in any given market there can be 20-50 different insurance companies that offer the same plans. The important thing to remember is that all 10 plans are standardized by the center for Medicare and Medicaid services (CMS).
For Example, that means that a plan F, from company A is identical in coverage to a plan F from company B, C, D, etc…down the line. They are all standardized, so you know you’re getting the exact same level of coverage from one company that you’d be getting from another.
What isn’t standardized is how much these companies charge for these plans. So, those same two identical F plans can vary drastically in monthly premium from different companies for the EXACT SAME LEVEL of coverage…sometimes up to $150 difference…for identical coverage. There are many reason for this difference in price, but it just doesn’t make sense to overpay for a plan when you can get the exact same plan and coverage from a more competitively priced company.
This is where we can help you shop and compare. No, price isn’t everything, but we can show you the many different factors involved when choosing a Medicare Supplemental plan… just give us a call and we’ll spend as much time with you as you need so you can make an educated decision and choose the best plan at the best price from the best company for YOUR specific needs.
While Medicare covers 80% of your bills and your supplemental plan covers the other 20%, you’ll still need to get a stand alone prescription drug plan for your medication needs. This is called your Medicare Part D. Just remember, Part D for “Drugs.” There are many different drug plans available from many different companies. They all have different drug formularies (that means different drugs that they do and don’t cover), different monthly premiums (what they cost each month), different deductibles, different copays, different mail order options and different preferred networks. You want to make sure you find the best drug plan for the specific medications that you’re taking and your pharmacy of choice.
Choosing a drug plan out of a hat can not only limit the medications you need, but it can literally cost you thousands extra if you’re on a lot of medications and you choose the wrong plan. We have a few tools we use to ensure you get the best drug coverage at the best price…just give us a call and we’ll walk you through the entire process. The closer you get to age 65, the more direct mail marketing pieces you’ve no doubt been receiving in your mailbox from every insurance company under the sun. Let me guess…you have a stack of mail and marketing pieces just from insurance companies that’s over a foot high? A large portion of those marketing pieces are likely from Medicare Advantage plan companies like Humana, Aetna, United HealthCare, Cigna-HealthSpring, Wellcare, Amerigroup, and BlueCross BlueShield.
Before you get tempted by one of these “zero premium” Medicare Advantage plans, give us a call so we can explain the pros and cons of Medicare Advantage plans to you. They CAN be a good solution for some individuals, but by no means are they a first recommendation and there are many reasons why that I’ve covered in another video. The most important of which is; Medicare Advantage plans REPLACE original medicare as your primary coverage.
If you choose a Medicare Advantage plan, that is now your primary coverage and Original Medicare will not be paying your medical claims directly. When you have a Medicare Advantage plan, Original Medicare Pays the Insurance Company of the plan you choose and the private insurance company THEN pays your claims. If you’re not aware of what this is called…I’ll tell you. It’s called having a middle man. Having a middle man is rarely a good scenario in any situation and your healthcare is certainly not an exception. This is just one of many drawbacks when choosing a Medicare Advantage Plan. Just give us a call if you’d like a thorough explanation and that way you can decide if a Medicare Advantage plan is right for you. You can also view our video called “Medicare Advantage Pros & Cons” for a more in-depth perspective on these specific plans.
So, in closing…once you turn 65 and have Original Medicare Parts A & B, you basically have three options for health insurance coverage going forward.
1.) Stick with just original Medicare and take the chance that you’ll never land in the hospital and have to pay 20% of a huge hospital bill. Not something I’d recommend.
2.) Keep original Medicare and add a Medigap plan to pick up the other 20% which will give you 100% coverage…this is simply the smartest choice and what I encourage all of my clients to do. Which of the 10 different medigap plans to go with and from which company is the question…we can help you with the answer…just give us a call.
3.) Go with one of the many Medicare Advantage Plans available and forgo your Original Medicare as your primary coverage. This is not what I’d typically recommend, but they can be a good fit for some individuals such as those that have both Medicare AND Medicaid together. For instance, those that have Medicare & TennCare or Medicare & the pink QMB Card. If you fall in this category of having both Medicare AND Medicaid, there are some great, zero premium Medicare Advantage plans for you to choose from with many added benefits at no cost to you.
Just give us a call and we’ll let you know all of your options. Again…there’s no need to stress about these decisions…just call us for a free, no obligation consultation…we’ll take the guesswork out of it. You CAN make a wrong decision that can end up costing you thousands over the life of your insurance policy, so just call us and we’ll help you make the right decision the first time.
Remember, Medicare doesn’t cover everything…so give us a call at 1-800-431-5431 and let us help you zap the gap.