PANIC!!

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by David S Edge

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Maureen’s son called and was in a panic. His mom was in the hospital and he just found out she was diagnosed with West Nile
Virus!

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His mom, Maureen has just turned 65 a few months earlier and had signed up for a Medicare Advantage plan because she was healthy and there were no major medical issues that ran in her family. But now, they realized she would immediately hit her “Maximum Out of Pocket” which was $5,000 a year with accumulated co-pays on her Medicare Advantage plan she selected. She never dreamed she would get sick and spend that kind of money in co-pays during a calendar year. She usually just had her yearly wellness check which was at no cost on her Advantage plan, as well as the no cost to see her primary care physician.

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In discussing this with her son, he remembered her explaining the difference between a Medicare Advantage network plan and a Medicare Supplement “Medigap” plan where she would have a monthly fee but no co-pays. Maureen asked her son to call our office to see what her options were.

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After reviewing her enrollment date, we found that she was still in her first twelve months of her trial period with Medicare. This meant that she could drop her Advantage plan and go back to original Medicare and select a Medigap with a Part D drug plan… no questions asked!

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They were both thrilled and switched as fast as we could complete the applications for a first-of-the-month start on her new plans.
It’s not that her current Advantage plan was bad, it’s just that she was going to spend a lot more in co-pays than the $138 a month for her Medigap premium that would cover all her Medical portions of leftover bills after Medicare paid their portion.
Not sure what your coverage is? Do you remember the difference between a Medicare Advantage plan and a Medicare Supplement Medigap plan? You might want to attend one of our many Medicare Workshops conducted monthly and have a refresher course for your options.

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Remember, Annual Election Period started October 15th and runs through December 7th if you want to switch
Medicare Advantage or Part D prescription drug plans. Call us! We can help!

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“After reviewing her enrollment date, we found that she was still in her first twelve months of her trial period with
Medicare. This meant that she could drop her Advantage plan and go back to original Medicare and select a Medigap with a Part D drug plan… no questions asked! ”