Medicare Questions: Sorry, I can’t help you.by Denise Early on Oct. 25, 2012, under Health
It’s the Medicare Open Enrollment Period and I’ve been busy talking to lots of people about their Medicare choices. I’ve had to tell several people I cannot help them. Here are two true stories:
Shopping for a lower Medigap premium
Sue (not her real name) has always had a Medicare supplement. Last year, her Medicare supplement premium went up once again as she turned 76, so she decided to shop around for a better deal. She found a much lower premium for the same Plan F and she grabbed it. I can’t name names but I sure would like to because this company gets lots of new business by offering the lowest premium in town – and then raises their premium more than 30 percent each year.
So Sue was once again shopping for a Medicare supplement when she called me. I asked her if she is healthy and she said “yes”. Then I took out a Medigap application and ran her through the health questions. Turns out she had one of her carotid arteries cleaned out recently, and now she’s in great shape. Unfortunately, there is a question on the application about having been diagnosed with, or treated for carotid artery disease. Sue must answer yes to this question – so she would be denied coverage by most Medicare supplement plans. There are two companies I know of that would accept her, but they would bump her up to a higher rate which is over $300 per month (in Arizona).
I got a call from a man who said he is 77 and has a Medicare supplement and a Part D plan. He said he wanted to look at his options for his Medicare coverage because he had received lots of mail telling him to do just that.
I asked him if he was happy with his supplement and if he could afford the monthly premium. He said he is very happy with his supplement which leaves him with no co-pays for his medical care. (Medicare pays first and his supplement pays second.) He said he thinks his medigap premium is reasonable.
I told this man he has the best coverage possible, and unless he is interested in Medicare Advantage, he doesn’t need to shop around. We talked briefly about Medicare Advantage and how it compares to Medicare plus a supplement. We also talked about the mailers he has received, all of which were from Medicare Advantage companies. I told him this is all junk mail for someone like him who has excellent coverage and is happy with it.
I am a lousy salesperson. I think people should stay where they are if their coverage is working for them. I feel bad about telling someone she has to live with the bad choice she made about her Medigap plan. I could sign that lady up for Medicare Advantage…. except that I think she has the best coverage for her age, even with the higher Medigap premium she is now paying.
There are plenty of people out there I can help with their Medicare choices. It is a luxury to be able to tell people the truth – that I can’t help them.