Going on Medicare is a traumatic experience because the information is voluminous and confusing. How do you sort it all out? How do you choose a broker or agent to assist you? Those are just some of the questions most seniors ask themselves.
The easiest way to find a broker is to ask your friends who they used and if they were happy with the results. If you have group coverage, ask the HR department if they can put you in touch with their broker. Many of these group brokers do not handle Medicare but know someone who does.
Otherwise, you are stuck cruising the Internet to determine who could help you. Very dangerous way to go as you don’t know that person’s history or if they are even qualified to help with Medicare enrollment. If you do that, make sure you check references before you meet the broker or agent.
The other approach is to call the insurance companies and get them to send you someone who can help. The only problem is that agent is only going to know his/her own plan so you are not learning about what else is available. Once you’ve chosen that person, you can then begin thinking about the type of plan you want. Please remember that Medicare allows you to choose a Medicare Supplement but after the first 6 months on Medicare you have to prove you are healthy to change plans. The Medicare Advantage plans only ask one medical questions and that relates to end stage renal disease.
Additionally, deciding to go on Medicare requires you understand some basic facts about Medicare. If you’re employed and your company has more than 20 employees you can get Part A and remain on the group coverage. The only other consideration is if your group drug coverage is creditable under Medicare rules. The other issue to be aware of is the plan an HSA? If it is you cannot stay on that plan and go on Medicare. The HR department is aware and can assist you. If your group plan has less than 20 employees then you must go on Medicare Parts A & B. Very basic but misunderstood by many seniors who continue to work past age 65.
I’ve met many seniors who are on a group plan with more than 20 employees and enroll in Part B. Money you don’t need to spend unless the monthly group premium is greater than the cost of Part B and your choice of a plan. That’s where a broker can help you decide the best course of action for you to take.
Realistically, you need to have a budget for Medicare and stick to it. In 2017, Medicare Part B costs $134 a month. You must have Parts A & B to go further. Then you have to decide if a Medicare Advantage plan with drug coverage makes sense? Typically, in Nevada, the HMO plans have no monthly premium. The PPO plans have modest premiums of $35-$47 per month. These type of plans are very well received but it’s your choice if an HMO is what you want. With the HMO your primary doctor refers you to specialists in your plan only. Going out of network is not an option and you end up paying the entire bill. The PPO plan does not require referrals but does offer out of network services but at a higher cost.
Lastly, there is the Medicare Supplement world. There are 10 different plans offered and Medicare determines the plan design and the carriers decide the premium. With a Medicare Supplement, you also have to consider getting a stand-alone drug plan. Typically, the Medicare Supplement plans can cost $30-$250 per month depending upon the plan. That’s why a budget is so important. If the broker assisting you asks what your budget is, he/she is just trying to gauge what type of plan would work best for you. When you pick a specific Medicare Supplement plan the pricing could have a monthly swing of $100 between multiple carriers, so why choose the most expensive one?
There are 23 drugs plans in Nevada and most people don’t have a clue on what will or will not work for them. That’s where the broker earns his/her commissions. They know how to choose the best plan for your needs by going to Medicare.gov and figuring it out for you. A good broker will sign you up for a drug plan that meets your needs, even if he/she doesn’t get paid but because it’s the right thing to do.
Lots of choices and options within those choices. Pick a reputable broker who knows the local market and can advise you of the best options for you.
Len Barend, broker
The Barend Agency Inc.