Major Advantage Insurance

This is a serious concern. Especially in rural North Georgia. So, please read the entire post.

Medical providers and those who work around seniors are telling them to drop their Medicare Advantage plans and go back to Original Medicare.

This is a big problem in underserved communities, like ours.

Every year leading up to and during the Annual Enrollment Period, I see medical professionals on social media telling people to stay away from Medicare Advantage.

Some even call it "Medicare Disadvantage."

Their recommendation? Drop your plan and go back to “straight Medicare” aka Original Medicare.

But here's what they're NOT telling people-

…the lasting financial impact of the decision on the beneficiary.

Original Medicare Parts A and B leave beneficiaries responsible for deductibles, and generally, 20% coinsurance on Part B services, with NO annual out-of-pocket maximum protection.

That’s the gotcha.

See, the medical provider is guaranteed their 80% from Medicare. But the beneficiary is left with 20% of the cost. I can’t tell you how many times I hear from people who are now in collections for that 20%, after being given this advice.

Further, Original Medicare does NOT include prescription drug coverage, dental, vision, or hearing benefits.

Did you know that someone on Medicare, incurs a lifetime penalty for not having prescription drug coverage? Thank congress from 2003.

We absolutely support the decision to enroll in a Medicare Supplement plan, which covers Original Medicare’s deductibles and coinsurance. But the reality is that many people can’t afford it.

Anyone who wants to enroll will be required to pay hundreds of dollars in monthly premiums. Additionally, drug plans can cost up to $216 per month! The majority of people we meet with cannot afford this.

Not to mention, depending on their situation, they may have to qualify through medical underwriting.

None of this is ever mentioned as a caveat to consider, because those medical providers and well meaning neighbors on Facebook are not health insurance professionals.

This is what happens when untrained and unlicensed people give advice. They may be well-meaning. But they aren’t YOU. They don’t know your financial situation, your other doctors, your meds… YOUR needs.

Look, I’m not a doctor- would you take medical advice from me without any training, schooling, or licensing?

I need you to think about this for a second.

Let’s say someone on Medicare follows the advice they saw online, drops their Medicare Advantage plan, and then finds out afterwards that they can't qualify for the Medicare Supplement they wanted.

Or maybe they think they won't have all these holes in coverage by just having Original Medicare because "the doctors office said to do it that way" and they end up with a lot of expensive surprises. (Ironically, I know someone who will respond negatively to this post, but they’re literally the example in my mind, right now.)

Now, they're potentially facing significant out of pocket medical expenses, prescription drug costs, and they may have limited opportunities to change their coverage again.

That's not just bad advice.

It’s irresponsible and dangerous, and can have serious lasting financial consequences.

Let’s be clear- we have no preference in what you choose. We are plan and company agnostic. Our job is to support the client. Moreover, we will work with their doctor’s office to help them understand the choice.

So I'm not saying Medicare Advantage is perfect or that it’s for everyone… cause it isn't. I'm certainly not saying Original Medicare, paired with a Medicare Supplement is a bad option. For many people, it's an excellent choice. For the majority of people we meet, it is simply unaffordable.

Between the two of us, we have over 40 years of experience in this industry, and we can promise you that choosing Medicare coverage isn't nearly as simple as these social media posts make it sound.

Medical providers are experts in treating patients.

Medicare agents specialize in understanding the insurance coverage. Both have important roles, but those roles aren't interchangeable.

Why should we be wary of medical professionals giving incomplete insurance advice that could financially hurt the very people they're trying to help? Because that is not their profession.

I know— the billing person files the claims. But that still doesn’t make them licensed experts in insurance. Their job is to collect the payment for the provider.

Here’s the kicker- we WANT the provider to get paid. We also want the best possible coverage for our client, without compromising the quality of care.

So if you're going to tell somebody to drop their Medicare Advantage plan, you better understand and explain what you're telling them to give up.

And that is the crux of the issue.

The rural healthcare system is fractured. We’re trying to do our part to help fix it. Let’s work together to transform the healthcare experience for our most vulnerable.

https://www.mymajoradvantage.com/