One thing that I go over with every one of my personal clients, is the difference
between Medicare supplements and Medicare Advantage. let's face it, every
senior is overwhelmed with options. Just in my home state there's over 30
different options for Medicare Advantage plans this year (filmed in 2008) 10 to 20 different Part
D plans and dozens of insurance companies that offer Medicare
Supplements and then they have a through J K or L, so dozens and dozens and dozens
of options. So everybody wants to streamline. Everybody wants a shortcut
and they all say, "Sylvia just give me the BEST plan." But there is no
"Best Plan." Oh how I wish there were. There are good plans that fit different people
differently, so it's great to have a lot of different tools in my toolbox here.
Medicare Advantage and Medicare supplement are both great plans, I put my
mother on one plan, I put my father on the other plan, one fit him much better,
She based on her health how she doctors how much she travels another one fit her
better, so let's just talk about the differences between Medicare Advantage
and Medicare Supplement. Okay. Medicare Supplement, I like to call this a
"Cadillac" plan. It's a Cadillac because it is extremely flexible: You can go to ANY
doctor that accepts Medicare and ANY Hospital in the nation. You're not
restrained by any type of network. You're going to pay a FLAT fee monthly, so it's
great if you want to know your budget to a "T". You'll know exactly how much you
pay a month. So I'm saying $120 dollars a month (based on 209 rates. This is going to vary based on
where you live in the country) your age, whether you smoke, male or female. It's a that's
a good rule of thumb to say a 70 year old is going to be around $120 dollars or
$130 dollars a month. And then you'll also have on top of that your drug coverage another
$33 a month on average. So a flat a hundred and fifty dollars a month that
you know you'll spend every month each and every month. All year, whether you use
it OR NOT. That's the key. Okay vs. Medicare Advantage Plans. Medicare
Advantage plans, like I said, there's many different plans based on where you live
in the country, but these are the most popular plans: $0 zero premium, so you would
have zero monthly premium and most of these plans have the drugs rolled in so
it's your Medicare Advantage and your Part D in MA PD together, both
for zero dollars a month. So over here where I said that you had complete
knowledge of what your budget will be every month, because you know you're
going to pay $150 bucks --whether you use it or not-- over here you have no idea
really how much you're going to spend a month. If you don't use it at all
clearly you're going to spend zero dollars in premium, but if you use it a
lot you're going to pay as you go. So I love the scenario of envisioning these
two separate products Medicare Advantage is an Ala carte restaurant Ala carte. When
you go to an Ala carte restaurant (say MCL Cafeteria, one of my favorites) you pay as
you go. If you get the corn, the potatoes, you pay for the turkey, you want pecan
pie? You want jello? My kids bankrupt me because they want to put every single
thing on their tray. I'm pretty cheap to feed there because I only want the pecan
pie, I want some milk and I like mashed potatoes. You know, very cheap just pay
for what you use when you go met advantage you're going to pay what you
use so for example like I said this varies tremendously I want product you
buy where you are in the country but in general to see a regular family doctor
about ten dollars a month I mean ten dollars a visit to see a
specialist maybe 20 to 30 go to the emergency room maybe seventy to a
hundred dollars what really gets expensive if you are in the hospital
overnight and that could be anywhere from let's say a hundred dollars to two
hundred and fifty dollars per night many different limitations based on the
policy but you get the point you pay as you go if you don't use it at all you
have zero cost that month versus a Medicare supplement it's going to be a
flat fee every month I'm going to pay that flat monthly premium for a year and
it's going to be the same whether I use it or not so if I have open-heart
surgery I need a transplant I need my leg amputated and a prosthetic and
therapy still going to cost me $120 a month the downside of that is if you
like my dad and you never go to the doctor you're paying a hundred and
twenty dollars a month each and every month so you look at somebody that goes
to the doctor twice a year how much were they actually paying for that doctor
visit because they'll say oh it's free when they actually go to the doctor
they're not digging in there get for a copay they don't pay anything
at the doctor so they love that but what's their actual cost right so their
actual visit was custom $500 if they went twice they might be a lot happier
with a Medicare Advantage plan where if they only went to the doctor twice and
it was a regular family doctor they went twice last year their total cost
out-of-pocket would have been $20 now they would have had to dig in their
pocket for that copay and some people just don't like that they don't like
having to get their checkbook out or get some cash out every time it's just not
for them they'll pay more for the flexibility of having it all paid for
and having a set budget and now also the big difference is of course your access
to providers with a Medicare supplement you can go to any doctor any hospital
accepts medicare so it's completely flexible across the nation you can put
it in your pocket and go out traveling and you know you're not going to have
trouble with Medicare Advantage depending on the type of product that
you bought and there's many different types of products that fall under the
Medicare Advantage umbrella private fee for service PPO HMO cost plans there's
many different types of plans some have a much wider range of doctors that
you're eligible to see some are a lot more restrictive with the HMO model so
depending on which type of plan you have you might not want to travel it might be
too much of a hassle or you might not want to take the risk of spending six
months a year in Florida with at your second house this might be a better fit
for you budget is always a big consideration right this is $120 a month
this is zero dollars a month which one's cheaper what's the bottom line like I
said everybody wants a shortcut I don't know what's the bottom line I don't know
what your actual cost will be if you can tell me with certainty how much medical
care you're going to need this year you're going to go to the ER you're
going to break your wrist you had bronchitis in the winter if you can tell
you a certainty I can tell you exactly how much it would cost you here and
which plan will be better but you can't so I can't tell you which one's actually
going to save you the most money you can look at your past history and see based
on the last five years which one would have come out more economically for you
but insurance is all about risk and what you feel comfortable with so the total
risk right here is that 120 times 12 your total risk on Medicare
Advantage of course is going to be the floor most plans have a ceiling and will
see every plan have a ceiling soon I think legislators coming where that you
can't pay more than a certain amount typically three to five thousand dollars
once you hit that amount you wouldn't pay any more of the year so if this plan
is a four thousand dollar plan and we know over here this plan is a fourteen
hundred dollar plan we can see you have double the risk but you also take the
risk that you would save more money on this site so I go back to what I started
with there's no best plan there's a lot of good plans there's a lot of good
tools that we as insurance agents have to serve our clients we need to talk to
each client as an individual and like I said like my parents I don't necessarily
sell the husband and the wife the same plan and that's one thing that people
get confused about they said Sylvia I really liked you I really like what you
sold me can you talk to my sister and then I go and sell their sister
something completely different then they're flummoxed and they're saying
well which one of us got ripped off which was the best plan you know there
there is no best plan when I look at you as a client look at your help how you
doctor your budget what you feel more comfortable with like I said this is can
be more inexpensive but you're just not comfortable digging in your pocket for
those co-pays as you go along you like the certainty of knowing what your
budget is going to be based on your comfort level we can recommend what plan
that we feel is going to be best for you talk to us at Gordon marketing talk to
your independent insurance agents we want to serve you
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