Since my Dad started helping folks with Medicare in the 90s, Martin and Associates have been partial to Original Medicare paired with a Med Supp and Part D policy.
Why?
It gives folks the most freedom of choice: you can see almost any doctor anywhere in the country. There are no network restrictions. Med Supps also covers many of the gaps of Original Medicare: getting you as close to iron-clad protection as possible.
How do we know?
My own grandmother had Original Medicare with a Medicare Supplement and Part D.
Back in 98’, she was hospitalized at Hoag Hospital for pneumonia. When my Dad went to pick her up to bring her home after 30 days, she was extremely short of breath. Turns out, she was having congestive heart failure! A short hospital stay turned into a very long hospital stay – 110 days to be exact.
She had access to the world-class doctors at Hoag; a private room overlooking Newport Harbor; in and out of intensive care multiple times; fresh linen every day; three meals a day; three shifts of nurses daily; physical therapy, speech therapy, occupational therapy; her own private doctor coming to visit her; every test you can imagine available to her during her stay…
How much did she owe at the end of it?
She paid exactly $0 out of pocket. FOR ALL OF THAT!!! That is how good this coverage is. There’s a reason why my Dad calls it, “the Cadillac of Healthcare.”
In recent years, Medicare Advantage plans have had their day in the sun. Many people are attracted to these plans because the premiums are SO LOW; sometimes even $0 a month! There are also many additional “perks” to these Advantage Plans. Some include gym memberships, grocery benefits, vision and dental benefits, to name a few.
Why do we not heavily market these plans at Martin and Associates? While Medicare Advantage plans are a great fit for some, we realize that beneficiaries may not have as much freedom of choice as they would with Original Medicare. We are always happy to talk about these plans with our clients: we just want to make sure they are going into them with eyes wide open.
Sadly, not all brokers take this approach. Because Medicare Advantage is the private sector’s version of Medicare, there are huge commission pay-days to be made here. Some insurance companies have been incentivizing independent brokers with hefty commissions to sell their plans.
CMS is finally cracking down on these incentive programs. They are setting fixed amounts that brokers can be paid by the insurance companies regardless of what plan their client chooses.
Another provision aims to reduce cold calling and aggressive marketing tactics. You know all those mailers you get in the Fall? And all the ads you see on TV? Hopefully, these new provisions will curb some of that.
Also, the insurance companies will be required to send their beneficiaries a notice between June and July that reminds them of what all their ancillary benefits are – so they can make sure to utilize the benefits they qualify for.
I’m glad CMS is cracking down on the overly aggressive marketing, and also making sure beneficiaries know what their plan’s benefits are.
If you have found yourself stuck in an Advantage Plan that is not the right fit, or you have questions about Original Medicare + a Med Supp policy, hesitate to reach out!