Question from Bruce:
My cousin and his wife just went on Medicare Part B. Ten months ago he said he wanted what I have, Supplement Plan N. I talked to him yesterday and according to my cousin, they just signed up for a Supplement that comes with dental, vision and other benefits. When I told him he didn’t get a Supplement, rather an Advantage Plan, he was surprised. Can they still change to original Medicare with a Supplement? And will your office talk to them?
Answer
You’re correct Bruce. If a plan has dental and other ancillary benefits, it’s not a Supplement. I’m almost certain what happened to your cousin and his wife is they enrolled in an Advantage Plan from the same company you have your Plan N with thinking it was a Supplement. Two of the three major players in the Western PA Advantage Plan market also sell Supplements. Your cousin was either misled, misunderstood, or a bit of both. It’s so common and extremely upsetting that this not only continues to go on but seems like it’s become difficult for seniors to get sound and reliable advice when choosing their Medicare plan. This industry has become some overcrowded with agents and many are desperate to sell policies or may not understand the differences between Supplements and Advantage Plans themselves. We often hear from people who were told HMOs and PPOs work the same as Supplements but are less expensive and come with extra benefits like dental, vision, hearing, and OTC allowances. Because commissions on Advantage Plans are so much higher, especially when enrolling those who are new to Medicare, many agents choose not to explain the Supplement option or will tell the prospective client things like, “You don’t’ want those. They’re too expensive and don’t come with dental and vision.” There are so many more differences between Supplements and Advantage Plans than that and it’s wrong for an agent to take away a senior’s choice so flippantly and selfishly. Doing so could cost someone tens of thousands of dollars. Every single day we meet people who have gotten bad advice or were victims of misleading information or unethical sales practices.
My agency may be one of the very few, if not the only, in the area who pays agents a salary. This allows us to take our time training and we generally don’t allow a newly licensed agent to sit with a client on their own for at least six months and even then, they’re always withing earshot of our most tenured staff members in case they need some assistance. The salary also eliminates the pressure of being forced to sell policies to pay their bills. It also ensures people who meet with us always get unbiased advice. I’m sorry I’ve written so much lately about this topic. I wish I could move on from it. But until the bad behavior is reduced or eliminated, I’m going to continue warning people, especially during this time of year when the deceptive advertising ramps up and most people on Medicare are limited to 53 days of the Annual Election Period (AEP), from October 15th to December 7th, to shop and change plans.
As for Bruce’s cousin, we would love the opportunity to sit down with him and his wife. They have 6 months from their initial Part B effective date to choose any Supplement letter plan without having their current or prior health issues considered. And they can change from the Advantage Plan they were enrolled in very seamlessly, without needing to contact the agent they used or the company they were enrolled with. For those who may be in the same boat and didn’t realize they weren’t enrolled in a Supplement, there’s a 12-month trial period where those who went on Medicare B for the first time also don’t need to go through medical underwriting.
Now, maybe after hearing the risks vs rewards Bruce’s cousin and his wife will want to remain on an Advantage Plan. They offer tremendous potential for premium savings of up to, or more than $1,000 annually per person as well as much as $2,000 or more per year in real dollar value of ancillary benefits. Just over half of all Americans on Medicare choose HMOs and PPOs for these reasons. We have over 4,000 current clients on Advantage Plans and expect to enroll more than ever this AEP. But at least those who come see us understand those risks and have the chance to choose a Supplement knowing them. They could also be one of many who, despite higher premiums, save money because those on Supplement Plan letters G and N that we recommend never get bills that exceed $226, the amount of the annual deductible. And unlike Advantage Plans, there’s also no need for authorizations for, or waiting on, medical services to be approved or the possibility of being forced to get physical or injection therapy prior to the insurance company agreeing to pay a claim for an MRI, CT scan, surgery, or other services. When explained, this is the number one reason people choose Supplements and are willing to pay higher premiums and forgo the extras Advantage Plans offer.
If you would like to make an appointment for a no cost consultation, give us a call. If coming to one of our offices isn’t convenient, we can talk over the phone or set up a virtual internet meeting. And for those of you who don’t live in PA, I’m licensed in over 20 other states to provide Medicare plans.
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