Understanding Medicare is truly a “choose your own adventure” type of experience. Thankfully, you have options available, but it can quickly become overwhelming as you navigate the choices. Do you need Medicare Part A only or do you need Part B? Is Medigap or a Medicare Advantage plan best for you? What about Medicare Part D? Is that a waste of money or a sound investment for your future? Questions like these are why we at Peel & Holland recommend working with a local medicare agent before making any final decisions.
Quick Guide to Medicare Basics
If you’re new to all of this, here’s a quick Medicare insurance breakdown:
- Everyone at age 65 must sign up for Medicare (even if they’re still working and have insurance through their employer).
- Medicare Part A: This is hospital insurance, which also includes some coverage of nursing facilities and hospice care.
- Medicare Part B: This is the medical insurance portion which helps cover outpatient care and your doctor’s services. This may also pay for some medical equipment such as a wheelchair or walker.
- Medicare Part C: This is the Medicare Advantage plan, which is Medicare purchased from a private health insurer and usually has different pieces of Medicare bundled together under one premium.
- Medicare Part D: This is prescription drug coverage so you can get the prescriptions you need at an affordable cost.
Which “Medicare Adventure” Will You Choose?
Now that you have a starting knowledge of Medicare enrollment, we would like to warn you that there is an easy way, and a much harder way to select your options. It’s up to you to choose your own “Medicare adventure.”
Which of these two paths would you prefer to experience?
Medicare Adventure #1 (Warning: It’s a bumpy road.)
You’re only a few months away from turning 65 and all of your friends are telling you how complicated it is and how you better start researching . . . well, yesterday. Yep, you’re already behind. So, you’ve printed out the “Medicare And You Handbook”, and your highlighter is ready.
You’ve already seen on Medicare.gov how to start the enrollment process. Now you just need to figure out which plan is best for you. You read about Part A, Part B, Part D… oh, wait, there’s a Part C, too, and then you discover Medigap coverage which has its own version of the alphabet (A-N with a few missing letters in between).
Never fear, you can figure this out! You decide on a plan, bypassing Part D and the Medigap insurance.
Happy Birthday! You’re 65! And your Medicare coverage has begun.
A few months later, you find out you’ll need a medical procedure, but it’s not available close to home. So, you head to an out-of-state provider. Thankfully, all went well, but then bills start pouring in a few weeks later.
And they keep pouring in.
You’re quickly overwhelmed and unsure what exactly you’re paying or if you even should be paying.
Then, one of your Medicare claims is denied.
Instead of focusing on your recovery, you’re resubmitting claims, buried in paperwork and bills. Your 35-year-old son is trying to help, but he’s just stressing you out even more. Recovery gets pushed to the back burner as you both work to sort out the complicated billing system.
Is this the “adventure” you were hoping for?
Medicare Adventure #2 (Worthy of a 5-star review!)
Happy almost birthday! You’re about to turn 65 and two friends are talking to you about their Medicare experience.
One seems a little on edge and stressed.
Your other friend explains how she just met with her local insurance agent.
She called and made an appointment and a few days later she sat in the office and discussed:
- Financial goals
- Current medical needs/treatments
- Prescription drugs
- Lifestyle during retirement
Her agent, a local Medicare expert, walked her through a few options, showing her the pros and cons of each one. She feels confident she made a good choice and isn’t paying too much.
You decide to take your friend’s advice and call the same agent. You now have the same level of confidence when it comes to your Medicare plan.
But the real test comes when you use the Medicare coverage you’ve chosen.
A few months later, you see a specialist some tests and a procedure. You’re quickly recovering, your new prescriptions are mostly all covered, and now the bills are showing up. Most of them match your Explanation of Benefits, but there are a few that don’t. You’re not worried, and simply make a call to your local agent for a little help. After investigating, your agent lets you know she’s resubmitted a claim for you, and she explains the other two bills you’ll need to pay.
You’re feeling healthy, and haven’t wasted hours on the phone with the hospital’s billing department.
You sigh in relief.
The Difference Peel & Holland Medicare Experts Provide
“Medicare Adventure #2” is the sort of experience thousands of Peel & Holland Medicare clients have taken over the years. The clients we serve receive custom, no-cost advice. And we’re real people just like you, not a faceless call center agent or washed-up television actor (don’t you just hate those tv commercials?).
At Peel & Holland, here’s what you can expect.
- You are the focus, not the provider. Our licensed insurance agents are independent. That means they’re not held captive by any one health insurance provider. What does that mean for you? We will search through various plans to find a Medicare provider that fits your goals and budget.
- You’re talking with knowledgeable local insurance agents. We don’t just sell insurance plans; our agents invest tons of time in training every year to ensure they’re equipped to handle your Medicare questions.
- Think you might move in a year or two? We can help you switch plans.
- Was your Medicare insurance claim denied? We can help you make an appeal and resubmit a claim.
- Have questions about a medical bill? You’ll have someone local to call for support. We never want you to pay a bill that your insurance should cover.
- You’re free to get on with life, and not spending time on complicated research. Our agents have experience working with a variety of insurance providers. We do the research for you, check out what each covers, and shop for the best rates. Everyone likes options, but when you’re trying to navigate this on your own, it can quickly feel stressful. We take the time to show you the best options for your personal needs.
- You won’t pay extra for choosing to work with us. Our services are free with no obligation to enroll. Peel & Holland is not paid by you, but by the insurance provider you choose. Our advice comes at no cost to you.
- You’ll know your plan fits local needs. Medicare enrollees in Kentucky, Indiana and Tennessee have different needs than people in Colorado or California. Shopping plans and rates on your own can could leave you unprotected. For instance, what if your local doctor or hospital doesn’t offer a specific test you need? Will your plan cover another hospital’s testing center? Or what if you need to travel to a hospital a few hours away for surgery? We have insights to which local providers accept which Medicare plans. Obviously, this is very important to know.
- You won’t have to worry about learning the ABCs of Medicare. From Medicare Parts A B, to Part C, to the Medigap A – N options, to Medicare Part D, we can present you with the best mix of plans. Yes, there’s a lot of information online, but it can be too much to sift through. When you have Peel & Holland as your local Medicare expert, decisions become much easier. As you start your research, our Medicare Glossary of popular terms you’ll hear might just come in handy.
So, which Medicare path are you going to take?
Schedule a free consultation by calling Jill Lewis at 270.527.6168. We’re excited help you navigate your healthcare options with confidence.
(No obligation to enroll)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.