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Medicare Missives...from the Beach

Case of the Week


As Woody Guthrie once said, "you may know someone in a similar situation or you yourself may be in a similar situation"

Many years ago when I was in the Group Insruance market I had a weekly blog post entitled "Case of the Week".  It highlighted a particular situation a client had dealt with and how we addressed it.  I believe it is easier to understand the pitfalls of Medicare when examples are illustrated with real-life experiences.  People occasionally still ask why I stopped doing them. 

I am hoping to make this a weekly blog post, to augment my videos, with one example from the previous week for illustrative purposes in the hope that it brings some clarity to a confusing process.

Yesterday I received an email from an existing client in Haverhill, MA.  She is older, has limited income and is currently on Traditional Medicare with a Supplement and Drug Plan.

She saw an ad on television, that promissed her cash back in her Social Security check, free dental and meals.  Without checking in, she enrolled herself in this Advantage plan.

Unfortuantely, AFTER enrolling she checked with her Dr and discovered the her PCP does not take the insruance.  She also discovered that the plan has copays, something which she was adament she cannot afford.  The carrier representative who enrolled her failed to explain the network restrictions, drug costs and copays.

She has already called the original carrier as we as the new one to cancel the new plan and got back to what she had.

Unfortunatley, she has discovered it isn't as easy to reverse as she had hoped.  

Luckily she is in a state that does not underwrite the Supplments, but she will need to wait until January (for a February 1st effective date) to make the change back as Open Enrollment has ended.  Her PT copays alone will cost her more than the fixed cost she would have paid.  

Be careful!  Making a change to your medical plans without all of the facts and a neutral 3rd party to assist you understanding the pros & cons can lead to unpleasant surprises, or worse(!), when you go to use your plan.







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