It’ s annual Medicare Open Enrollment (Oct 15-Dec 7) time and Medicare beneficiaries are being asked to make Medicare health plan choices that include many private insurance products (e.g., Medicare Advantage plans and supplemental Medigap policies). Who are you turning to for Medicare plan advice and information? The Medicare beneficiary is being bombarded with TV commercials, mail solicitations, and telephone calls to buy various private Medicare insurance products. If you have been on Medicare for a number of years, you probably are unfamiliar with the reality of today’s Medicare private health plan marketplace.
Your FIRST source of Medicare plan advice and information should NEVER be a commission-paid insurance representative (unless, of course, he/she happens to be a trusted family member)! They get paid to sell you specific private insurance products and therefore will not have YOUR best interest as their number one priority.
The statements above are not meant to disparage the value of the commission-paid insurance representatives. They serve an important function to the Medicare beneficiary and can provide valuable Medicare plan advice about the products they sell. Because they are paid commissions, do not expect them to give unbiased (objective) information about their products or about the true worth of Medicare options they do not sell. They will not warn you of possible pitfalls associated with their products and will downplay any concerns you might have about their products. The commission-paid insurance representative should be one of the LAST sources for Medicare plan advice and information AFTER you have collected and digested Medicare plan advice and information from unbiased (objective) sources.
It is up to you, the Medicare consumer, to educate yourself about your Medicare plan options BEFORE seeing a commission-paid insurance representative. Some representatives (and websites) downplay the fact that they are earning commissions with every private Medicare Advantage or Medigap sale they make so it up to you to ask the salesman “are you being compensated for selling the products you are recommending?” If the answer is yes, do not expect the information you receive to be totally unbiased and in your best interest.
Where can you get unbiased Medicare plan advice and information? Unbiased information comes from our government or from organizations that are NOT making money on the products they recommend. Our government representatives are NOT allowed to give you advice or steer you to any particular insurance product.
The Best Sources for FREE Medicare Plan Advice and Information
- Collect Medicare Background Information–Two federal government documents are must reads for every Medicare beneficiary:
- Have you done your Yearly Medicare Plan Review? (two pages)-an excellent overview of actions you need to consider and the contact information to have your questions answered.
- Medicare & You 2017 (132 pages) If you didn’t receive a copy in the mail (or tossed it by mistake), you can get another paper copy by simply calling Medicare at the phone numbers given below or you can download a digital copy online. READ it from cover to cover and use a highlighter to emphasize important passages that affect you. Perhaps if this document were called BEWARE YEARLY CHANGES TO MEDICARE 2017, then you might be more inclined to read it.
I cannot emphasize the importance of these documents enough as the starting point for all your Medicare inquires and decisions.
2. Talk to Unbiased People Paid by the Government to Assist You
You (or your representative) can get FREE one-on-one help from the federal government or your State Health Insurance Assistance Program (SHIP). I would recommend the federal government contacts shown in the figure above for general information. On the Medicare.gov website, go to the search box at the top, and type in “forms, help, & resources” . Your first choice will be the website page where all important contact information is listed. I recommend you save this website in your bookmarks. I do not recommend spending too much time on the Medicare.gov website where you can get bogged down in a labyrinth of information that is delivered in twenty different ways. If you get sucked into a maze of increasingly consumer-unfriendly webpages, then return to the “Forms, Help, & Resources” webpage to start over.
Most of the Medicare plan advice and information you will personally need for your specific situation will come from a SHIP representative. All SHIP contact information can be found on the website listed above or by calling the federal government (1-800-MEDICARE). If you do not want to listen to all the options, then simply say “agent” and wait to be connected to a live person before asking for your state’s SHIP phone number.
SHIP is a federally- funded program that is available to provide FREE and objective (unbiased) Medicare plan advice and information. Sometimes SHIP representatives will provide face-to-face sessions if you need it. Some of the Medicare plan advice offered by SHIP representatives includes:
• Helping decide when and how to get your Medicare coverage
• Comparing the various options for receiving your Medicare benefits with your particular needs in mind
• Reviewing situations involving both Medicare and your state’s Medicaid program
• Helping you determine if you are eligible for extra assistance such as Medicare Savings Programs or Medicare Part D Extra Help.
• Deciding if you need additional coverage (like a Medigap policy) or different coverage
• Determining if you already have other health benefits (e.g., Veteran’s, retiree, TriCare) in addition to or instead of Medicare
• Comparing various ways for you to supplement your Medicare benefits and, in some states, help you compare benefits and costs of specific plans
I recommend you start information gathering before the annual Medicare Open Enrollment even begins. SHIP representatives get very busy in late November and early December as Open Enrollment comes to an end. You need to sleep on and digest any Medicare plan advice you are given.
If you do not feel comfortable talking on the phone, a close friend of family member can do it for you. It is not a bad idea to have the Authorization to Disclose Personal Health Information Form on record at Medicare if this close friend of family member also serves as your Medicare healthcare advocate. Every Medicare beneficiary should have at least one person who can act as a patient advocate when they are UNABLE to do so for themselves. Because my mom has me help her navigate the increasingly complex web of Medicare benefits, she filled out the form naming me on this Medicare form.
The Bottom Line
You wouldn’t expect a salesman selling Apple iPhones to steer you to a Samsung Android phone nor a BMW salesman to give you information about why the better car for you would be an Audi. So why do we make decisions based solely on what a commission-paid insurance broker tells us?
The first source of Medicare plan advice and information should NEVER be a commission-paid insurance broker! They get paid to sell you specific private insurance products and therefore will not have YOUR best interest as their number one priority.
The high cost of health care has changed the Medicare environment because payers (the government and employers) are passing more healthcare costs onto the Medicare beneficiary. Today many retirees are faced with changing (and reduced) retiree health benefit options and must make decisions that could translate into unintended consequences in the future. Today, the individual Medicare beneficiary is expected to learn what are the best Medicare options for him or her. Our government will not do it for you. Your former employer will not do it for you. The private insurance companies see you as a customer for their products—nothing more!
Armed with the Medicare plan advice and information obtained from the unbiased sources listed above, you can then ask the right questions and make intelligent Medicare choices. Your next step would be to go to the government’s Medicare Plan Finder, where you can get plan-specific information without the sales pressure from a commission-paid representative.
BB’s Medicare Open Enrollment: Where Do I Begin –how to navigate the government’s Medicare Plan Finder website
BB’s Medicare Open Enrollment: Stand-Alone Prescription Drug Plans –assuming mom stayed with original Medicare
Zeroing In On The Cheapest Medicare Part D Plan –assuming mom stayed with original Medicare
BB’s Medicare Open Enrollment: Medicare Health Plan Choices –BB collects information about the Medicare Advantage plans available to her mom
Evaluating Medicare Choices For Mom–Conclusions –learn why my mom chose to stay with original Medicare + Medigap F policy + the cheapest stand-alone Part D plan instead of changing to Medicare Advantage