Ask the Medicare Specialist
QUESTION:
I’m turning 65 in November and going on Medicare. I’m getting overwhelmed with solicitations and information in the mail as well as TV commercials promising free this and that. Are prices and plans different if I go through one company or another, or one agent/agency or another? What separates them? Is there an advantage of working with one over another?
ANSWER:
The amount of mail someone turning 65 like yourself receives from government agencies, Medicare insurance companies, and agents/agencies is crazy. I can’t even imagine what is spent on mail and TV commercials.
The question regarding the differences in pricing and plans between one company and the next is a bit complicated since those on Medicare have two choices in types of plans they can purchase: Supplements, often referred to as Medigap, and Advantage Plans which are HMO’s or PPO’s. When it comes to Supplements, which are highly federally regulated, plans are labeled with letters A through N and provide the exact same coverage and access to doctors and hospitals regardless of the company who offers them. The only difference between companies selling the same letter plan is cost. There can be as much as a $50 to $60 difference in monthly premiums for the same plan letter.
With Advantage Plan HMO’s and PPO’s, coverage, access to doctors and hospitals, as well as premiums vary between plans and companies. There can actually be vast differences even within the same company. Another difference between plans and companies is what ancillary benefits are offered such as dental, vision, Over the Counter (OTC) and hearing aid Allowances, etc., and how generous they are. And, unlike Supplements, where there are only nine plans to choose from, there are approximately 80 or more Advantage Plan HMO or PPO’s available in Western PA.
As far as the difference between going directly through a company or an agent or agency, there are many, especially with one that provides the support and services we do at The Health Insurance Store, which I will go over shortly. First of all, let me mention that prices and coverage are the same either way. However, when contacting a company directly, you are only going to be presented with their plans and none from the competition. If you contact an Advantage Plan company, you aren’t even going to be given the Supplement option or have the many differences between the two types of plans explained. This is the most vital information someone going on Medicare for the first time needs to have in my opinion. There are risks and rewards for both and the choice one makes the first time he or she enrolls in Part B can have a lifetime of consequences. Again, this will not be explained when going directly through a company.
Is there an advantage of using one agent/agency vs another? Absolutely. First of all, you want to use a brokerage, like the Health Insurance Store, who is appointed to provide plans from every competitive
Supplement, Advantage Plan, and Part D prescription company on the market, which ensures unbiased advice. But just making sure the right plan is chosen is not enough. My mission when I opened The Health Insurance Store almost 14 years ago was to advise every client based on what was best for them, not based on getting paid the highest commission, or any for that matter. We never charge a fee for consultations, and I estimate that 50 percent or more of the clients we meet are advised by myself or another of our licensed agents to stay on the plan they currently have or choose one they can get through an employer or company they retired from.
In addition, my other goal is to provide our clients with the best customer service and support they have ever had. One of our mottos is to treat every client like they are our own mom or dad. We advocate and protect our clients in the event they have claims denied, receive erroneous bills, aren’t getting all the services and benefits they are entitled to, and any other problem or issue even remotely related to their policies. We also ensure our clients always have the plan or plans that provide the best value year after year. In addition, we have a staff of more than 10 people who are dedicated to client services. We also provide access to counseling with our prescription drug caseworker, who specializes in helping clients burdened with expensive medications. Tony has become very good at hunting down programs and foundations that save our clients thousands, even tens of thousands of dollars in drug costs.
And lastly, I want to give back to my community. I started a 501 (c) (3), T.E.A.C.H., which is 99% funded through proceeds of The Health Insurance Store. Among our missions is to provide support and mentorship to at risk kids as well as introduce them to science, art, athletics, and volunteering. Please visit our website at Teachpa.org for more information. We also get involved in raising money and often match donations for other community projects and programs. Among our bigger endeavors was to raise $33,000 for the victims of the 2016 Connellsville flood that affected almost 200 families. Last Spring, we also helped raise more than $15,000 for three local volunteer fire departments that couldn’t hold events during the pandemic that help pay for station expenses and equipment. Last summer we also sponsored and organized a free youth and adult basketball league that was a huge success and had well over 100 participants.
Our project this summer is helping the Yough River Trail Council, who is the nonprofit tasked with the upkeep of an approximate 30 mile stretch of the Greater Allegheny Passage that runs through Westmoreland and Fayette Counties. They need to raise $17,000 in order to receive a large grant for a very big project that is scheduled to begin in the fall if the funding is in place. Please visit The Health Insurance Store website for a description of what is entailed. This section is often referred to as the best maintained and most scenic of the 150 mile trail. We want to ensure it keeps that title.
To that end, The Health Insurance Store is matching all cash donations up to $2,500 made by the public. We are also donating $10 for every individual health and Medicare policy and $50 for every Life insurance policy we submit until September 1st.
So, when you do business with us, not only are you protecting yourself and/or your family, but you’re also assisting worthy and deserving people, projects, and organizations.
If you would like to make an appointment for a consultation or have questions regarding today’s topic or any other that is health or Medicare related, give us a call, go to our website, or email me personally at aaron@getyourbestplan.com.