8 Things To Know When Picking A Medicare Plan

Recently in Wall Street Journal (October 18, 2021) there was an article titled "8 Things To Know When Picking A Medicare Plan".

Let's look at their recommendations and provide some of our own insight.

1. Supplemental insurance is usually the best option for people who can afford it or who have health issues.

Yes, we agree. But it's also great for those who don't need it ... right now.  As we age, it's more likely that we will need additional medical care, and after-the-fact, it may be impossible to switch from an "Advantage" plan back to a "traditional" Medicare plan, which may limit your access to care... when you need it most.

2. Having Medicare alone is risky.

Yes. We agree.  It's essential to have a supplement plan to cover the excesses you may be charged with your A and B plans.  It's also essential to have a part D plan, and NEVER have a gap in coverage.

3. Medicare Advantage plans are cheaper for seniors in good health.

Yes.  But how do you guarantee that you will always be in good health?  Advantage plans are great....if you don't need the coverage ... but not if you need comprehensive care, which can be outside of the network or simply not covered. And...when you do need that care...see questions #1 and #7.

4. Not all Advantage plans are created equal.

Agree.  They are all a lot different with different coverage, different drug coverage, etc.  Be sure you know EXACTLY what you are getting if you decide on an Advantage plan, and how your options may be significantly limited if you decide to return to a traditional Medicare plan in the future.

5. Supplemental plans are the better option for people who travel.

Yes, we agree. And it may be the only reasonable option for those who split their year living in different states (i.e. Snow-birds), due to the typical "network only" routine care limitations of most Advantage plans. Traditional Medicare with a supplement plan can be used at any facility and with any physician or provider who accepts Medicare.

6. Supplemental plans usually get more expensive as you get older.

Yes, this is true.  As you age, you will likely use a greater amount of services, which justifies the higher cost.  But the scope of coverage for non-routine care is typically better with supplemental plans than advantage plans. And...once again... see questions #1 and #7.

7. It can be difficult switching to ("traditional") Medicare with supplemental insurance (from a Medicare Advantage plan).

Yes, with some exceptions.  There are some limited periods of time when you can switch without answering health related questions which could otherwise result in rejection or higher premiums.  Some states also provide a similar "non-medical question" enrollment at any time.  However outside of those time periods, or outside of those states, you may be denied enrollment in any supplement plan, or be enrolled with very high premiums, if you choose to return to traditional Medicare. In such cases, you may be "stuck" in an Advantage plan...that isn't to your advantage.

8. Don't forget the "nuclear option".

Yes, there are times and situations where drastic measures can be taken to get back into a supplemental plan.  For example, moving outside of the Advantage Plan service area can provide an option for traditional / supplement plan enrollment.  But really, do you want to have to MOVE (sometimes to a different state) to get back to a traditional Medicare plan?  How much would you have actually saved by being in an Advantage plan if you have to pick up and move to get sufficient insurance coverage? And if you have to do this, is it because you are seriously ill?  Do you want to have to do this in addition to attending to your health issues?

Why we recommend TRADITIONAL MEDICARE coverage (A, B, D) with a supplement.

In summary, there are a lot of great questions and answers in this WSJ article.  But the bottom line for our recommendation is still the same:

For MOST people, TRADITIONAL MEDICARE and DRUG PLAN (A, B, D) with a supplement plan is, and remains the best option, now and into the future.  Advantage plans are not really an "advantage" in our opinion, unless you simply cannot afford Medicare B, D and a supplement.

Medicare Advantage plans are increasing as the way that seniors obtain their Medicare benefits.  It's projected to be >50% of plan enrollments by 2030.  But is that because it's a better plan? Or because it's heavily promoted and appears to be financially beneficial for seniors?  Or is it because prospective Medicare beneficiaries simply don't fully understand the tradeoffs that you accept by enrolling in an Advantage plan.

Regardless of all of this, .... it's our opinion that if you can afford the Traditional Medicare plan, with a supplement insurance plan and a Medicare part D (drug) plan...it IS and REMAINS your best option.  That is why we don't promote OR offer Medicare Advantage plans. 

If you are looking to obtain a Medicare Supplement plan for your Traditional Medicare coveage...give us a call. 1-833-362-7475 (1-833-DOC-RISK)  We are able to help you select and obtain a supplement plan.  We will also be able to provide you with a referral to an authorized agent that can help you with your Medicare D "Drug plan".