If you are eligible for Medicare, have Medicare Part A and B and are over age 65, you may have a Medicare supplement plan, a Medicare prescription plan or a Medicare Advantage plan to help you with your medical and prescription costs.
Ruth and her friend, Susie, came in my office. Susie was so confused about what medical insurance she has and asked for help. I asked to see her ID cards. She kept getting ID cards out of her billfold until she gave me three (3) cards. She had a Medicare supplement, Medicare prescription and Medicare advantage ID card. Then I asked her which were still in effect (which was she still paying for). “All of them”, she said. Oops! You cannot have both a Medicare supplement and a Medicare Advantage plan. Medicare supplement plans work with Medicare – once Medicare pays a medical expense then the Medicare supplement plan pays. Medicare Advantage plans pay instead of Medicare. (If this sounds confusing, call me,) How did Susie realize she might have “a mess”? When she called to schedule a procedure, her doctor told her that he does not accept her Medicare advantage plan. She thought she could go to any doctor who accepted Medicare. Susie and I were able to confirm that her Medicare supplement and Medicare advantage plans were both in effect. She has been paying for both plans for over a year! Her Medicare prescription plan had been automatically cancelled when she enrolled in the Medicare advantage plan because it included prescription coverage. Yes, Susie does have a mess. How did this happen? She’s not really sure. She was contacted by an agent to enroll in a Medicare Advantage plan that had lower premiums than her Medicare supplement plan. There would be copays at the doctor and hospital but that was ok. Were the pros and cons discussed or was the agent “hoping to make a sale” and make more than he would with the Medicare supplement plan? What are her options? First option is to keep her Medicare advantage plan and change it during the annual/open enrollment period. Second option is to cancel her Medicare advantage plan now. Since her Medicare advantage plan is with a company that Medicare has given low ratings to for at least the last 3 years, she can cancel it now and enroll in a Medicare prescription plan. This is called a Special Enrollment Period which is approved by Medicare. With this option she will keep her Medicare supplement plan. Susie decided on option 2. She is going to call Medicare and cancel her Medicare advantage policy and enroll in a prescription plan. Susie is also going to change the agent on her Medicare supplement policy to someone who will look out for her benefit and who she can contact with questions or concerns. Susie was glad she had come in with Ruth after she called 501-868-6650 and said “Caroline, can we talk?” How is your plan working?
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AuthorCaroline Beauchamp specializes in personalized life and health insurance solutions. Archives
September 2023
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