By Robert Remin
Before I reveal some more Medicare myths, I want to thank 5TJT readers for the overwhelming response to the first Medicare Myths article. Whether contacting me only for information or becoming a client your responses are always welcome, as my goal is to educate and take the confusion out of what I like to call the “Medicare puzzle.” See related articles here or on my blog at RobertReminInsurance.com. For those who missed the first Medicare Myths article or want to read it again you can find it at 5TJT.com, e-mail me at RobertReminInsurance@gmail.com with “Myths Part 1” in the subject, or text me at 914-629-7153 and type “Send Myths Part 1” and I will send you a link.
Myth 5. Your friends; family members; doctor; doctor’s office manager; other health-related administrators; nurses; and other people you know in the health-related industry from your PT to OT professional to your yoga, Pilates, kick boxing, and weight training instructor(s) do not know and in reality have little or no clue what the most appropriate Medicare plan is for you. They are not licensed or certified life and health agents and are not deeply familiar with the details of the dozens of plans and the changes to same that happen each year.
The professionals I mentioned above might prefer a particular carrier because that carrier may pay them faster than another or have an easier paperwork filing process. Their preference is moot when it comes to choosing the most cost-effective plan for you.
I am meeting a potential client this week whose wife (not 65 yet) works in the non-Medicare division of one of the largest Medicare carriers in the country. I think the client, who is on one of that carrier’s Medicare Advantage plans, was in shock when I informed him that his Advantage plan is not accepted at the major area hospital group his doctors would use should he ever have to be hospitalized. Who are you going to contact or speak with for advice and guidance for 2019?
Myth 6 (or Myth 5 Part B). The above advice also applies for your financial adviser, CPA, and Life/LTC (Long Term Care) agent—with the following caveat. Your Life/LTC agent has a Life and Health license but most, if not all, are not certified to present Medicare plans. I can assure you if their main business is Life/LTC they do not have the expertise nor time to adequately serve the Medicare eligible market. Ditto for the financial adviser and CPA. As a matter of fact, last week I presented a more cost efficient PPO Medicare plan to a Life/LTC agent who is currently in an HMO Advantage plan.
Myth 7. (There are more myths but I like stopping this week with an important halachic number.) Whether you are in an Advantage Plan in which the drugs are included or a separate Part D prescription drug plan, drug costs never change. Each carrier makes updates to their drug tiers and formularies yearly (see my blog if you are unfamiliar with tiers and formularies). You can be in a plan for 2018 in which you buy a tier 1 or 2 drug at low cost but in 2019 that plan changes the drug to a tier 3 or higher and/or a non-formulary and the cost skyrockets. Yes, sometimes it goes the other way and a drug can have a substantial drop in cost. The point is you want a professional working in the Medicare eligible market to be on the lookout in advance for you each year.
Happy Thanksgiving and Shabbat Shalom!
Robert Remin is an independent agent licensed and certified with all the pertinent Medicare carriers in the New York Metro area. As an unbiased resource, his only goal is to match you to the most appropriate plan. For any questions, or a cost free consultation, contact him at 914-629-1753, e-mail RobertReminInsurance@gmail.com or visit RobertReminInsurance.com.