It’s my understanding that the Oregon plans you represent are limited. Is it my best interest to work with someone in my state instead?

Question from Tamara: It’s my understanding that the Oregon plans you represent are limited. Is it my best interest to work with someone in my state instead?

Answer: Although today’s question comes from Oregon, it’s still pertinent to everyone, including those who live in Pennsylvania and any other state in the country. 

My answer to Tamara’s questions is an emphatic NO! We’re not limited whatsoever in plans we can advise someone to enroll in, and our advice never changes, based on the state someone lives in. The bottom line is everyone has just one of two options, a Supplement or an Advantage Plan, to help limit the costs of what Original Medicare doesn’t pay. Educating yourself on the differences as well as the pros and cons between the two choices is vital. That's what we provide first and foremost, in an easy-to-understand presentation we’ve used for 18 years. Once which type of plan a client prefers is established, recommending a specific Supplement or Advantage Plan is the easy part. And again, we can do that for you, or anyone else, regardless of where you live. 

Unfortunately, using an agent who resides in your vicinity or state doesn’t guarantee good advice, knowledge, or integrity. As I’ve written about on so many occasions, the vast majority of agents make recommendations based on which of the two options pay them the most commission, which is Advantage Plans by an eye-popping amount. Because of this, the risks of Advantage Plans and the rewards of Supplements often aren’t disclosed and explained. Advantage Plans can be a very good choice for many but not for all. When everything is explained and disclosed properly, I estimate that 65% of those who are new to Medicare choose a Supplement and 35% Advantage Plans.  There’s also a sizeable group of people with specific health issues who should never choose an Advantage Plan because out of pocket costs can be much higher and, in most states, after being enrolled in an HMO or PPO for 6 to 12 months, it can be impossible for those with several pre-existing conditions to move back to a Supplement.  

More and more Advantage Plan companies in multiple states, have been forced or decided not to pay commissions on some or all plans. This has exacerbated agent’s bad behavior as many will purposely not show Advantage Plans that offer the best co-pays and lowest Maximum Out of Pocket (MOOP) if they don’t pay a commission, instead steering clients to inferior plans that do. This reprehensible practice isn’t contained withing certain state borders. It’s going on all over the country. 

That will never happen at The Health Insurance Store. From the day we opened in 2008, our mission has always been to direct people to the option and plan that work best for them, regardless if we get paid or not. We’ve never wavered from that promise. I estimate that over 25% of those who come to see us for the first time are advised to stay on their current plan or choose one from a company or plan that doesn’t pay us commission, which may include employer or retirement options. We even determine qualifications for Medical Assistance and help those who meet the criteria apply despite not receiving compensation to do that. 

And there’s never a charge for a consultation or recommendation even if the final result is going in a direction that doesn’t pay us a commission. 

If you still decide not to use The Health Insurance Store, I have some advice and things to consider:

1. If you meet with someone and they don’t provide both Advantage Plans and Supplements to you as a choice, that means all they care about is a commission. You should run away. 
2. If an agent mentions Supplements but doesn’t go into detail, glosses over them saying they’re too expensive or only for people who are sick, they either don’t know what they’re doing or are once again only interested in selling what pays them the highest commission. Again, your best interests are not being considered.  
3. If you are lucky enough to work with an agent who goes over both Advantage Plans and Supplements in an unbiased manner, but recommends Plan G only and doesn’t mention Plan N, they’re lacking in knowledge. 
4. If you’re even luckier to find an agent who is unbiased and provides Supplement rates for both plans G and N but refuses to help you choose a Part D prescription plan because they no longer pay commissions, that should be another reason to give pause to working with him or her. At The Health Insurance Store, even though we no longer get paid to enroll clients in Part D, we find the plan that works best initially, explain the coverage and drug costs in detail, submit the application, and then make a recommendation each and every Medicare Annual Election Period on what plan will be best for the following year. 

The bottom line is you will never find an agency that is as ethical and works as hard as we do. Our job only begins when you allow us to enroll you in a plan. Afterwards, the agents and administration staff are always available and will get involved if you experience billing errors, claim delays or denials, have prescription drug questions, or there is any other concerns even remotely related to your policies. We make all necessary phone calls and inquiries until client issues are resolved. 

With questions regarding anything Medicare related or to make an appointment, give the office a call, 724-603-3403, or email me personally, Aaron@GetYourBestPlan.com.