New to Medicare? Make decisions on the merits of the plan, not the publicity – Pasadena Star News


Enrolling in Medicare is one of those personal milestones that every senior American ultimately passes – much like the first day of school, getting a driver’s license, the first election to college. ballot boxes or other milestones when they were younger.

But this stage of life requires serious decisions about health insurance, all designed to keep you as healthy as possible for the rest of your life.

It is especially an adventure during the registration time. TV, social media and mail are teeming with an avalanche of advertisements trying to entice new and existing members to make the “right” choices with private companies.

But Tatiana Fassieux will tell you that there are better ways than media advertising to base your Medicare decisions during the enrollment period – this year it’s October 15 through December 15. 7 – whether or not you want to make changes to your current plan. Seniors who turn 65 or change their lives due to a disability can apply at any time of the year, not just during the enrollment period.

Fassieux, with the nonprofit California Health Associates (CHA), notes that advertising using personalities or additional hanging benefits is how many insurance companies selling health insurance plans publicize their options, particularly targeting those who are already overwhelmed by the hundreds of medical choices available to them. .

Changes in Medicare for 2022

Such publicity directs seniors to companies that can sell them plans that don’t suit their individual needs well, said Fassieux, education and training specialist for CHA, the leading advocate for Medicare beneficiaries. in California.

“All health plans should cover basic Medicare services, but many also offer the ‘bells and whistles’ you may not need,” she said. “A health club membership or additional transportation can be appealing, but it probably comes at a cost.

“Of course, this is all part of the free market – every company presents its best product. Some people are savvy, but unfortunately others are not.

Linda Cardoza, director of the Health Insurance Advocacy and Counseling Program (HICAP) in Orange County, said she could tell when these announcements were appearing. That’s when calls suddenly spike to his independent, nonprofit agency that helps Medicare registrants.

“On late night television, someone will hear a personality presenting a really special advantage,” Cordoza said.

“The ads direct them to a phone number, but the person they get is a broker whose job it is to sell them the services of their business and not necessarily what they need.”

Tracking their local HICAP is the way to clarify what these locations mean and eliminate services that are unnecessary or overpriced, she said.

Ah, make decisions

Getting the best benefits starts with making good decisions based on unbiased information, said Fassieux.

And there are plenty of them around. The government has sent eligible people its annual “Medicare and You” manual which answers most of the questions registrants may have.

The book explains how Medicare Part A provides health care to any doctor or hospital in the country that accepts Medicare, but in order to reduce deductibles and payments, most registrants pay for Medicare Advantage HMO or Medical Supplemental additional coverage plans. , which are the subjects of these advertising campaigns.

Registrants can find at the back of the book a complete list of Medicare Advantage plans available in their particular county, in addition to Medicare Prescription Part D plans.

If a person wishes to benefit from regular (original) health insurance, they should also consider purchasing a supplemental health insurance plan through a trusted insurance broker at the time they are made. is eligible for health insurance for the first time.

(Insurance brokers may be independent and offer policy options with various companies or may only sell policies from one company and be paid out of commissions from that company. In California, brokers or agents must be licensed. Go to 0200-industry to verify a license.)

The complexity of all of these plans is often a shock to people who for years have had to deal with relatively simple employer health plans that change little each year.

“They are used to having only a few choices to make, but it’s quite different,” she said.

Oddly enough, one of the initial decisions for new registrants is where they plan to spend their retirement years.

Residents of Southern California have a choice of many health insurance programs and medical facilities in every county, but moving to this idyllic lakefront cabin or remote small town is a problem. Fifteen counties in California (mostly in the north) do not have Medicare Advantage plans available, and other rural areas have very limited services.

Living in Butte County, north of Sacramento, Fassieux has only one company that offers their Medicare Advantage plans.

She pointed out that those considering relocating to a place like remote Lake Almanor in Plumas County north of Lake Tahoe would likely have to drive several hours to Sacramento to get the most out of a Medicare Advantage plan.

“You have to find out what is available in your area and what the cost is,” she explained.

Another question is whether a registrant should pay extra for extended coverage in Medicare Advantage plans or get only basic inexpensive parts A and B, plus optional additional Medicare coverage.

“After all, some people think, I am perfectly healthy and never sick, why do I need something like this? she said. “We are all human and think we will live forever. We don’t want to think about our mortality.

She explained that a Medicare member with only minimal coverage can suddenly face an unexpected prescription that costs $ 300 per month or have a stroke that will require paying significant costs beyond the limited coverage. They will not be able to change their coverage until the next membership period.

“Planning for the future of your health is no different from financial planning. You must do both to prepare for the future. And there is no crystal ball to help you.

But a prudent strategy is to explore the major plans listed in the “Medicare and You” book, contact the different companies to find out about their offerings, and when questions arise, contact your local HICAP office (800-434-0222 ) where an impartial expert can give a fair assessment of your situation.

Making decisions about Medicare is certainly not an impossible undertaking for an individual – tens of millions of seniors have already successfully enrolled and made changes over the years.

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