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Who knows the answers to Medicare questions?

by on Nov. 17, 2009, under Health

I was talking to a client this afternoon who had just attended the Pima Council on Aging (PCOA) Annual Medicare program.  The program provides an overview of choices available to Medicare beneficiaries and highlights changes in Medicare Advantage and Medicare supplements.

My client, who is turning 65 in January, seemed overwhelmed by the information she heard – and she said she was more confused than ever about  making a decision for her Medicare coverage. 

Her husband has a Medicare Advantage plan and has been happy with it – and he has had some medical issues that have been taken care of without any hassles with the insurance company.  My client is healthy and able to afford a Medicare Supplement premium – but she’s not sure she should pay for something she might not use.

The PCOA program talked about the new Medicare Supplements that will be introduced in June 2010, and my client recalled that we had spoken about how attractive the Plan N will be  – with a low premium, but comprehensive coverage, and co-pays for doctors and the emergency room.

My client told a PCOA representative that she had heard she could join a Medicare Advantage plan in January, when she turns 65.  Then she could disenroll from the MA plan in June and sign up for a Medicare Supplement with “guaranteed issue”. 

The PCOA rep said this was not possible because seniors are locked into their MA plan through the end of the year.  So my client called me and said I had given her wrong information.  I knew this was not the case, so I looked at the “Medicare and You 2010″ booklet and found the information.  So here it is:

“Medicare and You 2010″  
Page 75  Section 2—Your Medicare Choices Medigap
If You Want to Buy a Medigap Policy   (the third to last point near the bottom of the page):  

If you join a Medicare health plan for the first time, and you aren’t happy with the plan, you will have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining.

— If you had a Medigap policy before you joined, you may be able to get the same plan back if the company still sells it.

— The Medigap policy can no longer have prescription drug coverage even if you had it before, but you may be able to join a Medicare Prescription Drug Plan.

— If you joined a Medicare health plan when you were first eligible for Medicare, you can choose from any policy.

So who knows more about Medicare?  I think I win this one.



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