We explain, in understandable terms, how insurance works...
We explain, in understandable terms, how insurance works...
The time of year, October 15th to Dec 7th, is where Medicare gives everyone in the country, who is currently enrolled in Medicare Advantage, the opportunity to assess what their current coverage is to be in the upcoming year, compare what is available next year and then, should the decision be to change, switch coverage for the next calendar year. This period generates a market frenzy because it occurs once a year for 47 days and encompasses some 30.8 million people nationwide. The sizable market attracts the entire breadth of marketing efforts: the multi state agencies, the direct mailers, the companies and local agents. And. Fraud.
The truth is, all marketing channels (company direct, TV, direct mail, local agents, national/regional agents) offer exactly the same companies and plans at exactly the same price. The only difference is the choice as to how you buy. Every marketer faces a lot of competitors with a lot at stake in a short period of time. Telemarketers especially are under pressure to convert prospects to enrollees quickly and move on to the next prospect so as to make the concept of the national/regional agency work.
The tactics are standard moves: swamp the media with ads offering free 'help': benefit reviews, provider lookups and benefit promotions. Stuff mailboxes. All designed to elicit a response from you. The telephone becomes a weapon. Scammers and fraud abound. Please know Medicare does not allow legitimate agents to cold call (a telephone call or in-person appearance without your explicit permission). So. Those who call (or appear) circumvent this by 'helping' you.
You can buy from the telemarketer who you never actually meet and are unlikely to ever hear from again if that's what suits you. The main problem with the phone is you only think you know who are dealing with.
You can buy direct from the company; work through voice menus to reach the company agents ... a person where English may or may not be the primary language.
You can buy exactly the same product at the same price from a local agent who meets with you on your terms and will be the same person in the future should you have questions or need help..
Choose whichever method makes the most sense for you. Remember, there is no advantage in plan benefits nor any difference in price to buy from whomever you choose.
Medicare Advantage plans, like all health products has moving parts that move in different ways depending on the health events. Everything has to fit together to make a plan that works for....you.
Consider why you have made the decision you've made to this point. If you've been in contact with an agent, you've discussed your circumstance and, hopefully, been presented with options to help you get a company and a policy that best fits your situation. Your insurance should be easy to use, perform as you expect and cost you the least possible under the circumstances.
If you are happy with your existing coverage. And. You accept the changes your company is making. And. Your company offers the same plan next year as the one you have this year, the likely best choice is...do nothing. Your company will automatically enroll you into the same plan for next year. To you, all the marketing efforts are just background noise.
If you are not happy with your coverage. Maybe the best idea is to first discuss your concerns with someone who really knows the actual situation, i.e. an agent (who provides accurate truthful advice based on discussing your needs compared to the options). Friends and family, in spite of good intentions are not medically qualified to know the actual situation. They know their actual situation, but your actual situation is not likely to be actually the same as theirs. Only you and your doctors know your actual situation.
If your company is not offering your plan next year, or for whatever reason, and you want or need to change, you can easily switch your coverage. There are lots of choices.
Independent agents have lots of choices. Choosing your plan is a process. First, confirm your physicians are good. Second, confirm your prescriptions are good. Third, check the Maximum Out of Pocket (MOOP) so you understand your maximum risk for the upcoming year. Fourth, look through your intended coverage to understand your risks. After you look at why you might choose a plan, then you can assess the perks that sweeten your choice. Considering perk(s) as a primary decision is not a good idea because trade-offs are made in other benefits that, if triggered, may cost you more than the perk(s) .
Should you, for whatever reason, discover after committing to a new plan it's not what you want or your circumstances have changed, or, was misrepresented, Medicare offers two 'outs'. If you are still within AEP, you can enroll in another plan; the 'Last Man Standing' provision is where the last plan submitted to Medicare is the valid one. Or. You can make a one-time switch in the MAOEP which is from Jan through March.
Extra Benefits have a number of different names that describe the same thing: supplemental benefits, or ancillary benefits or perks or bennies or pot sweeteners or incentives or just plain-goodies. These are benefits that Medicare does not offer but the plans offer because Medicare has expanded what can be offered. The companies have responded, depending on the plan: Over-The-Counter credit accounts where you can buy food/vitamins etc., pay utility bills, transportation, meals after hospitalization, fitness club memberships and so on. The latest is Premium Reduction, aka The Giveback (aka Rebate). Buy our plan and we, the insurance company, will provide a cash rebate in some form. However. Not all is as it seems. The benefits have to be funded. Somehow.
An attractive benefit-Here, usually means making you pay more-There. Whether or not that attractive benefit actually improves your year depends on how the upcoming year works out. The frosted over crystal ball. Think carefully about that attractive goodie. What is your situation. What is offered. What is your risk needing the actual medical benefits. An ethical agent will not recommend you increasing risk.
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