Hello Happy People! Welcome back to another episode of 65 and COunting. I’m your host, Adam Frye. I’m a Certified Medicare Planner and I’m here to ask the important questions you want answered by industry professionals. This show is for anyone and everyone who’s coming up on that important milestone of 65 years old. That means retirement, medicare eligibility, or you’re just plain interested in the world of retirement planning. Whatever it is, on this show, you’ll hear from the people that know it best.
Let’s take care of some quick housekeeping! This year's Annual Election Period is quickly approaching… It’s time to review your plans and make sure you’re on the most appropriate one for 2021! Hey, that rhymes…. New AEP Catch phrase? Either way, make sure to keep an eye on your inbox, because in the coming weeks, if you’re a current client of American Retirement Advisors, you’re going to be getting a VERY important email from us explaining how to get started with this year's annual reviews. If you aren’t currently a client of ours, what are you waiting for!? Give us a call to have your plan reviewed by a Certified Medicare Planner to ensure you’re on the most appropriate plan for the new year!
Also! Workshops! If you missed workshops this month, don’t worry! September registration for online and in-person workshops is live on www.123easymedicare.com or give us a call at 602-281-3898 to sign up! In-person workshops are still only in the Las Vegas area, and seats are limited due to COVID so sign up today!
Ok Folks! It’s time for another deep dive into one of the American Retirement Advisor Success Stories! If you remember last month, we took a look at one client's struggle and solution with the high cost of insulin and other diabetic supplies. This month we are going to take a look at the solution to Medicare Advantage Plans network restrictions when it comes to needing emergency and urgent care! Before I dive in to the details, here’s David Edge to read you the article we’ll be talking about titled, “Me Too!”.
(Article Reading)
Thanks Mr. Edge... Wow! There’s a story that kept me on the edge of my seat. Get it? Edge?
But in all seriousness, that was an intense story. There’s a lot of fear involved in a situation like that. With all the stress of having a medical emergency aside, when you’re restricted to a network, medical bills have a spot in the front seat of the anxiety-mobile as well!
If you are on a Medicare Supplement Plan, you won’t need to worry about a network when you experience an emergency. You will typically be able to go to any doctor and any hospital in the United States!
This article is important for those on Medicare Advantage plans who do need to think about networks when seeking medical care. But here’s the good news: All Medicare Advantage plans are obligated to pay for emergency room visits. We discussed this a little bit in last week's episode but I’ll go over it again because it is very important. Medicare Advantage plans are required to cover everything that Original Medicare covers but your out-of-pocket costs may differ. A Medicare Advantage Plan may charge you a co-payment for every emergency room visit, but you’ll still get the care you need, regardless of if you are at an in network facility or not.
What Gene experienced is what we in the insurance world call a “True Emergency”. That means he needed immediate medical care to protect him from loss of life or serious bodily harm. Insurance companies and Medicare understand the need for fast action in regards to your health, and are willing to make exceptions in these types of cases.
Now you may be wondering, Adam, what if I’m traveling and I get sick? Is that a true emergency? What should I do?
If you’re outside your plans service area, or “network” and you need to see a doctor, the good news is that Medicare Advantage Plans are also required to cover urgent care anywhere in the United States without imposing additional costs! Urgent Care is anything requiring immediate medical attention for a sudden illness or injury that is not life threatening.
What about your medications when you’re out-of-network? Pharmacy networks are national! If you lose your medication or are prescribed something new, you can fill it at any in network pharmacy. For example: If you use XYZ Pharmacy at home, and you need to fill something while you’re traveling, just use an XYZ Pharmacy!
All in all, if it can wait until you’re back home and in your plans service area, it should wait. If you want to see your podiatrist for some routine foot care, or get your next round of an immunization, be sure to receive that care in your home city! But travel without fear of high medical bills in the event of an emergency! And like Gene, if you are worried about getting the care you need in an emergency situation, and the doctor you need to see is not at an in network hospital, your plan is there for you, and will not put you in a situation where you’re left with outrageous bills!
That’s it for today everyone! Thanks so much for tuning in. Don’t forget to like the video, share it with your friends and family, and follow our page! Tune in next week for a special Newsletter Reading from David Edge! As always, have a great week!