On any given day, I can be on an appointment helping a client choose a Medicare Supplement and then go on to my next visit and they are very interested in a Medicare Advantage plan. How does one choose? Many factors go into that decision. For the most part, my clients that are on supplements have been self-employed and are very used to paying a premium for their health care. Their premiums have been anywhere from $800 to $2,000 and they still had to deal with deductibles and co pays. When they see an initial premium (Age 65) of $150 per month with no deductible and no copays, they practically hug me on the spot. They can continue to enjoy the flexibility of going to any doctor they want, whenever they want, with no restrictions of networks. If they travel six months out of the year, they don’t have to be concerned with being “out of network.” They have access to places like Mayo Clinic and Barrow Neurological Center. They pay a premium monthly for those benefits.
Advantage plans have the attraction of a zero premium. That being said, you’ll have to pay a copay when you see anyone for almost anything — primary care, specialists, x-rays, hospital stays, etc. Most Medicare recipients are on a limited income, and the zero-premium plans can have quite an appeal. That being said, you have to work within a “network” of doctors. If you have a Banner primary care physician, you can’t see a non-Banner specialist and vice versa. Helping someone with Advantage plans takes a lot of research to be sure they’ll be able to continue to see all their same doctors. While a healthy individual can save quite a bit of money, the out-of-pocket maximum for the year can be anywhere from $3,400 to $6,700 depending on the plan for a catastrophic illness like cancer or a kidney transplant.
A perk of the Advantage plans is that several companies have special plans for individuals with chronic illness like diabetes. Knowing those individuals have an increased need to see their specialist or have certain tests done, they typically will have lower copays and have some benefits like transportation and or gym memberships at no additional cost.
Finally, it’s a good idea to have a broker assist you with your very individual needs. Every client is different and there is no “one-size-fits-all” when it comes to your health care insurance.
Have questions about Individual or Medicare Insurance? Patty Vieira is an Independent Insurance Agent with 31 years of experience. She specializes in simplifying Medicare Insurance plans and quotes and finding the right plan to meet the unique needs for each client. Call: 480-220-7233, email: firstname.lastname@example.org, or web: www.insurancebypatty.com.Back to Top
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