Medicare Talk With Mike
By now, you’ve surely seen Joe Namath, William Shatner and Jimmie Walker on TV lately pushing Medicare Advantage plans? These guys got famous young for doing stuff that has nothing to do with healthcare, so you may want to think twice before believing anything they have to say about Medicare Advantage plans.
There are 54 million people in the U.S eligible for Medicare. Nearly 300,000 of those elders are here in Maine. And nearly all of us are overwhelmed by the junk mail and the TV advertising.
Here’s some reality:
Original Medicare includes coverage for hospitalization (Part A) and medical visits and procedures (Part B). Prescription Drug (Part D) coverage is available either as a standalone policy or as part of a Medicare Advantage plan.
Before you enroll in Advantage plans, you must have original Medicare, and you still must pay the Part B premium of $158 (in 2022). While Medicare Advantage plans include medical, hospital and drug coverage, they can also feature extra benefits not offered by traditional Medicare, such as dental, hearing and vision coverage, transportation, free meal delivery and/or, a refund of the Part B premium.
“Don’t sign up for a plan over the phone without a complete review of the features, benefits and potential costs of a plan,” says Wheelers Insurance Medicare specialist Mike Newsom. “Direct Mail and TV pitches are designed to do one thing – generate a phone call. If it seems too good to be true, it probably is.”
Mike does encourage our customers to bring in the questions these ads generate? Can I get some free dental coverage? Maybe. Some plans require your dentist to be in a provider network, some provide reimbursement, but none of these plans provided unlimited dental care.
The same goes for medical care, vision and hearing aid benefits. Generally speaking, with a Medicare Advantage plan, there is a limited network of providers, and benefits might only be accessible by using one of the in-network providers.
As for the Part B buy-back, that comes in two varieties. One is a plan that is so stripped of benefits that the buy-back is only beneficial if you avoid going to the doctor when you are ill. That kind of plan is only ideal for a very limited group of people – the ones who don’t want to buy health insurance at any cost.
The other kind of buy-back plan is one that is available only to low income individuals. Mike says “There are many Mainers who are eligible for some assistance with their Part B premium and/or their out of pocket costs for Medical claims or Prescription Drug costs. It’s worth looking into,” but he goes on to caution us about responding to direct mail and TV ads for this kind of information. Instead, he recommends that individuals contact the Social Security Administration directly (1-800-772-1213 from 7am to 7pm, Monday through Friday) to apply for Extra Help. You can also apply online at https://www.ssa.gov/extrahelp.
Says Mike, “Our advantage is that you can book a face to face appointment, look at and compare plain offerings, and make educated choices, without pressure phone sales tactics.”
No pressure sales: a win for you.