A blog about Medicare. What you and your employees need to know
Cool – Wanna Be the Cool Kid?
Author: Lora Drummond
Medicare Transition Specialist
#35 – 52- Cool – Wanna Be the Cool Kid?
Many of our clients will ask, “Which is more popular? A Medicare Advantage plan or Original Medicare with a Medicare Supplement and a drug plan?” Insurance company marketing has incorporated ‘popularity’ into a person’s decision when choosing a plan. What’s ‘cool’ isn’t a reason to pick a plan. What’s cool is when a plan provides benefits appropriate to an individual’s needs.
Wanna be the cool kid? Refer your employee to a Medicare expert dedicated to helping folks find plans specific to their needs!
Certified Medicare Planners® guide based on facts and a person’s particular needs when acting as a Medicare fiduciary. They believe that making sure a person understands their options is paramount, so they recommend starting with Medicare education. Then they qualify a person’s needs and explain plans that provide coverage appropriate to meeting those needs. Helping folks maintain their wellness goals, keeping their doctors, and managing their costs should be the priority. Not being guided by the marketing they see on TV telling them what they should choose.
From a general facts perspective, the Kaiser Family Foundation has compiled some data on Medicare Advantage trends so far this year.
- More than 62 million people, including 8 million younger adults with disabilities, rely on Medicare for their health insurance coverage.
- Medicare Advantage plans are growing steadily in popularity. More than 26 million people are enrolled in a Medicare Advantage plan, accounting for 42 percent of the total Medicare population, up from 24% a decade earlier.
- Nearly two-thirds of Medicare Advantage enrollees are in plans that do not charge a premium (other than Medicare’s Part B premium). The addition of supplemental benefits, like eye exams, dental, and fitness benefits, adds to the appeal of these plans.
But when comparing a Medicare Advantage plan to Original Medicare with a supplement and drug plan it’s important to consider:
- The government regulates basic Medicare coverage. So whether you choose Original Medicare or an Advantage Plan, the basic coverage is the same. The extras, specific networks, and costs are what differentiates them.
- Compare costs of premiums, prescription drug utilization, chronic medical conditions, deductibles, and out-of-pocket maximums.
- Geographic considerations- number of plans offered in your area and if keeping your doctor is important. Plans with network coverage will require you to use their doctors and limit coverage area.
- Medicare Advantage plans also come with out-of-pocket maximums (unlike Original Medicare); those amounts can be as high as $7,550 in 2021 for in-network coverage before the plan pays 100% of covered services.
- Medicare Advantage plans are marketed as having $0 monthly premiums. But remember, folks still pay Part A and B Premiums, and there are still coinsurance or copay costs when visiting a doctor.
- Original Medicare doesn’t cover dental care, vision and eyeglasses, hearing aids as some Advantage plans do. If those ‘extras’ are important, then you may not be satisfied with Original Medicare and a Supplement.
- Don’t forget about drug costs! 90% of Advantage plans have their own drug list, deductibles, and copays. Those coverages and costs change every year so you should re-evaluate your costs and coverage annually during Medicare’s Annual Election Period if you have an Advantage Plan so you can avoid costly surprises in the new plan year.
Transitioning to Medicare will be smoother if folks have an expert to help them compare their needs to what is offered. Medical needs will change as folks age so having a ballpark of low and high-cost scenarios should be considered when looking at plans and coverage.
Want to make the transition easy for employees leaving the company and help them feel ‘cool’ when they leave? Partner with Certified Medicare Planners® who are trained to help employees leave their group plan with confidence and move to Medicare stress-free.
You’ll look cool for recommending experts to help them.
How cool is that?
Need guidance on how to support your employees with other possible scenarios and helpful solutions?
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