In this episode of Medicare Simplified. we focus on the major questions you can ask as you review your Medicare options to give you the information you need to make the best decision for you
In this episode of Medicare Simplified. we focus on the major questions you can ask as you review your Medicare options to give you the information you need to make the best decision for you
Courtney Collen (Host): Welcome to Medicare Simplified: a podcast by Sanford Health Plan to help you decide which Medicare options are right for you. I'm your host, Courtney Collen. When choosing a Medicare plan, it's important to remember that Medicare isn't one size fits all. There are many ways to have Medicare coverage and each person should choose the option that best fits needs and lifestyle but it's important to know what you're getting and what to ask before you buy. To help break down Medicare Advantage and a lot more, I've got Jack Arnett, a manager at Sanford Health Plan, with me and we are having fun. Hi Jack.
Jack Arnett:
Hi Courtney. Thanks for having me.
Courtney Collen (Host):
We are talking about the benefits of working with an agent and why it's important. Tell us more.
Jack Arnett:
Sure. Courtney, there are so many options and this decisions that have to be made when a Medicare beneficiary, for that individual that approaches Medicare initially: when should I enroll? How should I enroll? What happens next? And then what additional coverage, you know, would be best for me? Working with an agent and again, a licensed, trained and certified agent is really, in my opinion, the best option. Insurance professionals have extensive training and education on the plans, which is vitally important and provider networks as well. So important when choosing additional Medicare coverage that your providers, your doctors, your specialists are part of that plan’s network. They typically work with multiple insurance companies. So it's not just a one-size-fits-all. People may choose different plans just based on loyalty to a particular provider or a network of providers. If they travel, you know, quite a bit, health, finances, all those decisions coupled together are important to make those decisions on additional coverage. And so a licensed, trained insurance professional will actually help that individual. They'll usher them through those decisions. So when it comes time to choosing that Medicare plan, that additional Medicare coverage, they're well informed to make that decision.
Courtney Collen (Host):
If anybody listening is like me, insurance is overwhelming. So, to have an agent to help walk you through the process, thank goodness. My next question, Jack, how do I find an agent to help?
Jack Arnett:
Sure. You know, my first bit of advice for those that may be listening is, you know, who is your primary insurance agent now? Maybe that individual that, that helps you with your auto insurance, your homeowner's insurance, your life insurance, perhaps they are also to trained and licensed in the Medicare field or have somebody in their office or that, you know, could recommend them. And so Courtney, if those options aren't available to that individual, give us a call at Sanford Health Plan. We can certainly connect you with an insurance professional that can help you, you know, weigh your options and find a plan that fits best for you. Simple phone call (888) 605-9277 and we'll connect you to one of our Sanford Health Plan partners. Over 70 brokered agents partner with us in our geographic footprint, as well as, as an internal inside sales team, that's ready, able, and willing to assist.
Courtney Collen (Host):
You know, typically Jack as a former journalist, I'm pretty skilled in coming up with questions, but when it comes to insurance I don't know that I'm the best at asking questions. So, tell me what are some of those important questions that we should be asking when it comes to working with an agent while shopping for Medicare?
Jack Arnett:
So Courtney, I've been a licensed insurance agent myself for over 25 years. And as I've grown and matured in my role, actually the first question I will ask a Medicare beneficiary are: what's important to you? Is it price? Is it benefits? Is it features? Is it network? That'll help me determine which course of action, you know, I should guide the conversation to. Typically, some of the questions that Medicare beneficiaries will have are, what are your coverage options? Do you have multiple plans you can choose from? What are some of the additional benefits that you, you know, may cover? A lot of times be, you'll say, well, ‘I doctor so infrequently’ or on the other side, ‘I go to the doctor all the time. Does that matter?’ And it does, it could definitely matter when it comes to the cost of some of the additional Medicare products. Can you afford the plan? There's a wide variety of options and prices when it comes to additional Medicare coverage. Some of the Medicare supplement plans can be in the hundreds of dollars a month. And some of the Medicare Advantage Plans actually have a $0 premium per month. So a lot of options to choose from when it comes to the individual’s desire for financial risk, we call that, you know, what is your comfort level. Travel, more and more people each year are, are traveling and with hopefully COVID maybe coming on the downside, I think more and more people will continue to travel. And each plan, be it a Medicare supplement plan or a Medicare Advantage Plan has different travel provisions. So if travel is an important part of that lifestyle for that individual, make sure you discuss that, you know, with your agent. Some of those additional coverages – dental, vision, hearing, transportation, gym memberships – if those things are important to you, make sure you ask your licensed insurance professional those types of questions.
Courtney Collen (Host):
I've also learned with insurance, timing is important. Jack, tell us why.
Jack Arnett:
Sure. When enrolling into Medicare, I would say the traditional enrollment period for most Americans is when you're turning 65, that magic age of 65. Though, more and more people are, are working beyond age 65. When retirement finally happens, when that's a definite, people absolutely need to be concerned about the different enrollment periods especially when it comes to Medicare Part B and Part D. For Medicare Part B, when an individual is first eligible if they don't delay enrollment because of additional coverage, their spouse or themselves continue to work and they're covered under that employer's group health insurance, when that is no longer an option, they do need to enroll into part B because if they don't, Medicare will actually assess an enrollment penalty and that penalty is actually 10% of what is that baseline premium. And that penalty stays with that in individual for life. Some that may be listening may be a little concerned. That's why, again, I go back to getting with your trusted advisor, your licensed insurance professional, to walk you through that. Additionally, when it comes to Medicare Part D, once that individual has enrolled in both Medicare Part A and B, they need to choose a Part D plan and here's the reason why: Medicare will assess a penalty for those that don't enroll into Medicare Part D. So people ask me, is it mandatory? No, it's not mandatory, but if you don't, and then when you finally do enroll, you'll be assessed a penalty. Medicare does that because they need all beneficiaries enrolled into Medicare Part D plans. It kind of offsets the low utilizers offset the high utilizers. So Medicare needs all Medicare beneficiaries participating in a Part D plan. Now that penalty is 1% of what Medicare calls the baseline premium. On a month to month basis, it doesn't amount to much, but some individuals made delay enrolling into Part D either because they just weren't aware, or they just chose not to. Now their healthcare needs change, they need prescriptions and they will pay, you know, significantly more for the same plan than somebody that did enroll when they were first eligible. So two unique penalties that Medicare will assess the beneficiary for not enrolling: the Part B penalty and the Part D penalty.
Courtney Collen (Host):
You talk about the magic age of 65, which leads to my next question. When can you enroll? Is that the earliest an individual can enroll in Medicare?
Jack Arnett:
Well, Medicare again – federal governments health insurance program for people that are turning 65 – but individuals that have been disabled for more than 24 months, regardless of age, are eligible to join Medicare. And then those that have been diagnosed with kidney failure or end-stage renal disease are also eligible, you know, for Medicare. The initial enrollment period into Medicare for those turning 65 is three months before they turn 65, the month of, and three months after. So it's actually a seven month window to enroll into Medicare. And then they have, you know, that similar enrollment periods when it comes to choosing that additional coverage. Again, a lot of dates, a lot of things to consider and again, get with somebody that's, you know, been doing this for a while. And he, or she, will be more than happy to walk them through all their options and help them make an informed decision. More and more people that we see, especially at Sanford Health Plan, just aren't aware. It's for no fault if nobody else's, but so many employers just don't know where to turn once their employees retire and what options they can give them. Medicare's website is outstanding. They do a great job, but nothing beats that face-to-face conversation, that coffee table, that the kitchen table conversation to explain the options. It doesn't go quick, you know, it normally takes a couple of visits to get through all the options and to, you know, help make some decisions but that's what we're here for. That's what a licensed, trained, certified insurance professional that focuses on Medicare plans that's our job. And that's what we're here for.
Courtney Collen (Host):
Yeah. A lot to unpack so we appreciate you helping us break it down for us, Jack. Thank you.
Jack Arnett:
My Pleasure.
Courtney Collen (Host):
Great information. If you'd like to learn more about the Medicare Advantage Plan options from Sanford Health Plan, visit align.SanfordHealthPlan.com or find more information in our episode show notes. We'll see you next time.
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CMS ID Number: H8385_ 829-499-563PODCASTArticleQuestions-PY2022-ND-SD_C, H3186_ 829-499-563PODCASTArticleQuestions-PY2022-MN_C
Last Updated On: 6.01.22 at 10:30 AM