The Medicare maze: Consider using a broker to navigate your choices after turning 65

Navigating the Medicare maze can be a tall task without the help of a professional.

Navigating the Medicare maze can be a tall task without the help of a professional.

When turning 65, many of my clients have told me they were totally confused when it came to making choices for Medicare. They are deluged with calls and information in the mail and don’t know what to believe.

Many have the opinion that it costs money to use a broker and hesitate to do so because of extra cost, but that is the farthest thing from the truth. A broker’s services are free to the client. They are paid commissions by whichever carrier the client chooses.

It is an important decision that needs guidance. It is a lifetime decision, and if someone chooses a Medicare Advantage plan without knowing whether it is best for his or her, you could be making a big mistake.

What you choose depends on your needs and your health history. It is important to know that you have a six-month period after your Part B goes into effect to select any Medicare supplement you wish. It is your Open Enrollment period and no medical questions are asked.

If you opt for a Medicare Advantage plan and are later unhappy with it, it may be too late. After that Open Enrollment period, you have to go through underwriting to qualify for a Medicare supplement, and if you cannot qualify, you are stuck in the Medicare Advantage plan for life.

The one exception is that in your first year in a Medicare Advantage plan, you can opt out and go to a Medicare supplement any time during the first 12 months.

So what is best for you?

It depends on your health and your income. If you can afford it, I would recommend a Medicare supplement. It costs more than Medicare Advantage, but you don’t have to worry later if you have a serious health condition. Once in the plan, as long as you pay the premiums you cannot be denied coverage.

While out-of-pocket expenses can be as much as $3,500 a year with a Medicare Advantage plan, there is $0 out-of-pocket expense with an F plan and just $183 per year (the Part B deductible) with a G plan.

There are two parts to your sign-up, if you get a supplement. One is choosing the right supplement, and the other is choosing the right Part D drug plan.

Here is an area where a broker can really help you. Many brokers help their clients make the call to Medicare and get quotes on what plans are best for them. It made a $5,000 a year difference with one client I helped.

Drug plans change from year to year, and in one instance, a daughter suggested they keep the same plan I had helped get for her mother for the next year. But upon checking, what cost around $1,000 one year went up to $5,500 the next year because three of her medications were dropped. I got her a plan that covered all her prescriptions for a total cost of $550 a year — a $5,000 difference.

So don’t hesitate to consult a broker. It won’t cost you anything and it could save you a lot of money.

You can only sign up for a Medicare Advantage plan when you are turning 65 or during Annual Enrollment Period that runs from Oct. 15 through Dec. 7. You can sign up for a Medicare supplement any time of the year, however.

Ron Bliss is an independent insurance agent in Carson City who assists individuals with health care of all types. You can reach him at 775-224-7169.


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