This week’s question from Gail
I’m currently a Pennie client at an insurance agency in Washington County. I would like to switch to The Health Insurance store in Forest Hills. Is that possible? I just turned 64, so I will also need recommendations for Medicare as well. When should I set up that appointment? I’d like to avoid any type of rush during the busy Medicare season.
Answer
Just Give Us a Call
We do help people apply for individual health insurance via Pennie, the Pennsylvania state’s insurance marketplace and Pennie clients make up a substantial portion of our total business. And yes Gail, we can become your agency of record. All you need to do is reach out to one of our offices and we will then call Pennie with you to make that request. we welcome anyone who acquired a plan through Pennie, Healthcare.gov, directly through UPMC, or Highmark, or from any other agency to become a client this way. You can then take advantage of all the no cost advocation services we offer which include disputing bills, appealing and fighting claim denials, helping to alleviate expensive prescription costs, and more.
As far as when you should set up an appointment with us to learn about the differences between Supplements and Advantage Plans, the pros and cons, and get price and benefit comparisons, that can be done anytime between now and the first day of the month you turn 65. There are people who worry and want to get some clarity and costs six months to a year prior. And if that helps ease some stress, great. Some people don’t want to come to the office more than once or have multiple appointments, so they wait to meet until when hey can first enroll in a plan, which is 90 days prior to their Part B effective date. However, we suggest making an appointment no later than 30 days before the Part B effective date so everything can get processed and new medical cards received before the policies start.
I also recommend those who work past their 65th birthday and get insurance through an employer come in at least four months prior to the time they plan on retiring, will be losing employer coverage, and/or their Part B will be going in to effect. There are forms that need to be filled out and steps that need to be taken in order to get Part B processed. We can provide those and give instructions on how to best go about that in addition to reviewing and comparing plans.
Avoiding the Rush
As far as avoiding the crazy rush that is the Medicare Annual Election Period (AEP) that starts on October 1st during what is known as the Pre AEP, when we can see plans and present materials for the 2023 plans but can’t complete applications. Those can be submitted as AEP takes full flight on October 15th and runs through December 7th. If you’re turning 65 or retiring between December of 2022 and February of 2023, if you can make an appointment prior to October 1st or after December 7th, it’s not a bad idea to avoid what is definitely our busiest time of the year. That being said, our agents have worked a combined 60 AEPs. We know how to schedule appointments and pace ourselves so we can ensure current and prospective clients get all the information and education they need to make the right choice.
A couple reminders as AEP is quickly approaching. Those who are over 65 and still working, but thinking of possibly retiring in 2023, do not have to take any action until they know exactly when they will be losing employer coverage. When that event occurs, it triggers a Special Election Period (SEP) to enroll in a Medicare Advantage Plan, Supplement, and/or Part D prescription coverage anytime during the year. In addition, I can’t say this enough; AEP is so important for those currently on Medicare. I still estimate that approximately one out of every two Medicare beneficiaries is on a plan that they are either overpaying for, have higher hospital co-pays or MOOP (Maximum out of Pocket) than they should, aren’t getting enough dental, vision, OTC, and other ancillary benefits, or even all of the above. If you’re not a current client with just a simple phone call or email, one of the licensed agents or I will let you know if you are on one of the handful of plans we consider to be most competitive, or an appointment to compare your current plan to others is warranted. Whether you have a Supplement or Advantage Plan, getting this professional advise is vital. Do not get caught up in thinking my premiums went up or down just a few dollars so I’m good where I am when it comes to Advantage plans and Part D. As far as Supplements, it’s highly likely you can get the same exact coverage for less premium than you’re currently paying.
Thank you!
If you have any questions or concerns regarding this column topic, or would like to make an appointment for a no-cost consultation, please feel free to give us a call – we would be happy to help. I’d like to remind everyone that I do a live call-in talk show called Medicare A to Z every 1st and 3rd Monday of the month on WMBS Uniontown, 590AM and 101.1FM, from 1 to 3 PM. You can listen in on their website, wmbs590.com.
Erie County Area
1105 West 12th Street, Suite – A
Erie, PA 16501
Phone: 814-920-5275
Fax: 814-920-5276
Fayette/Westmoreland County Area
121 North Pittsburgh Street
Connellsville, PA. 15425
Phone: 724-603-3403
Fax: 724-603-3402
Pittsburgh Area
21 Yost Blvd., Forest Hills, PA 15221
Mailing Address: 128 Forest Hills Plaza, Pittsburgh, PA 15221
Phone: 412-349-8818
Fax: 878-302-3149
Albuquerque/Santa Fe, New Mexico Area
821 Coors Blvd. NW
Albuquerque, NM 87121
Phone: 505-200-0069
Fax: 505-200-0073
Serving These Areas
We proudly serve the health insurance and Medicare needs of the following Pennsylvania areas: Connellsville, Uniontown, Greensburg, Mt. Pleasant, Scottdale, Irwin, N. Huntingdon, Murrysville, Monroeville, Plum, Lower Burrell, New Kensington, Pittsburgh, Plum, Oakmont, Penn Hills, Forest Hills, Wilkinsburg, East Liberty, Lawrenceville, Bloomfield, Natrona Heights, Leechburg, Washington, Morgantown WV, Latrobe, Monnessen, Jeanette, Erie, Edinboro, Northeast, Girard, Fairview, Union City, Harborcreek, Corey, Meadville, Waterford, Ligonier, Kittaning, Somerset, Waynesburg, Fayette County, Westmoreland County, Armstrong County, Butler County, Somerset County, Erie County, Crawford County, Venango County, Allegheny Valley, Pennsylvania
We proudly serve the following New Mexico areas: Albuquerque, Rio Rancho, Sante Fe, Bernalillo, Belen, Los Lunas, Espanola, Moriarty, Corales, Tijeras, Cedar Crest, Edgewood, Soccoro, Sandoval County, Sante Fe County, Bernalillo County, Rio Arriba County, Valencia County, Soccoro County, New Mexico
Not affiliated with the U. S. government or federal Medicare program.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.