Tag Archives: informed

A Happy Ending from Your Decisions

Vantage Point: Life Is Not Like The Brady Bunch

Growing up watching The Brady Bunch, I loved how when there was a problem, like Jan getting a bad perm, Greg having his first fender bender, or Marcia getting braces, it was always resolved in a happy ending by the end of the episode.

I didn’t think to question how Mr. and Mrs. Brady could afford to raise 6 kids and pay for a maid and the mortgage on a tri-level house. I know now, from raising my own kids, that braces are really expensive, and so is adding teenagers to your car insurance. Real-life decisions don’t always end as positively as a Brandy Bunch episode.

In my work, I counsel people who made a choice that costs them later. For example, if you don’t pick up prescription drug coverage when you first become Medicare eligible and then realize you need to add it later, you’ll get charged a late enrollment penalty. Many times in these cases, members have sadly told me that they didn’t know or that no one had told them. They’ve truly taught me the importance of staying informed.

Recently, I had the chance to meet with Callie Klein from COUNTRY Financial, and we found that we share a mutual desire to learn about each other’s professional services.

We know Medicare can be confusing, so we do our best to help people make sense of their options. Retirement planning can also be confusing, but Callie helped me to understand how choices like life insurance and long-term care can affect your financial future. Callie pointed out that people are living longer, and some people can spend just as many years in retirement as they did on their career. That’s what makes it so important to plan ahead, so your resources match your longevity.

As we enter a new year, I am reminded how fast time goes and how important it is to give some thought to your future now. Set some long-term goals rather than just short-term resolutions.

If you haven’t already and need help, I encourage you to seek out a professional like Callie. She showed a genuine concern for her clients and a desire to guide them toward the decisions that will help them attain their future retirement goals. Professionals like her can help you at least become educated and stay informed.

Most importantly, though, I wish you happiness in 2016, and I hope that, like an episode of The Brady Bunch, your biggest problems are resolved quickly and with a happy ending.

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant and Okanogan counties in Washington. She has four sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.

Medicare Advantage Mythbusting

Long View: Medicare Advantage Truths Might Just Change Your Mind

As I travel around the Illinois countryside, I hear the same misinformation about Medicare Advantage over and over. To tackle some of that, here’s a Q and A.

Question: When I join a Medicare Advantage plan do I lose my Medicare coverage?

Answer: No. If you have a Medicare Advantage HMO or PPO plan, a private health insurance company that has a contract with Medicare, like Health Alliance Medicare, provides the services instead of Original Medicare. People who disenroll from Medicare Advantage plans revert to Original Medicare. In either case, no one loses Medicare coverage.

 

Question: Will I be able to stay with my current doctors?

Answer: Probably, especially with Health Alliance Medicare. That’s why it’s important to check any plan’s provider directory to confirm your doctors work with the plan. People who select a Preferred Provider Organization (PPO) plan can use out-of-network providers, but they typically pay more when they receive services.

 

Question: We travel and might need to use the emergency room. Will Medicare Advantage plans only cover me for emergency care when I’m close to home?

Answer: No. Medicare Advantage plans cover out-of-area emergency and urgently needed care.

 

Question: If something serious happens and we need lots of services, could we predict how much we would pay for care?

Answer: Yes. Medicare Advantage plans have an annual Out-of-Pocket Maximum (OOPM), also called a Yearly Limit. When a Medicare Advantage member reaches that limit, the health plan pays 100 percent for Medicare-approved services. This amount doesn’t include the premium and other limited expenses. You can estimate what your expenses would have been last year on the Medicare Advantage plan you are considering.

 

Question: Medicare Advantage sounds good for me, but wouldn’t the premium be too costly for my 88-year-old mom?

Answer: Not at all. One of the best things about Medicare Advantage plans is the premium is the same no matter the member’s age. You and your mom would pay the same monthly premium if you had the same plan, unless either of you could get extra help paying for coverage based on your income.

 

Question: Would I have to deal with all the paperwork I get when I receive services from Original Medicare plus a Medicare Supplement plan?

Answer: No. You would have much less paperwork with a Medicare Advantage plan. In fact, that’s one reason Medicare Advantage plans exist, and I’m all for less paperwork.

 

Remember, the Medicare Annual Enrollment Period, or AEP, runs from October 15 to December 7. That’s the only time most people can change their coverage for the following year.

If you are thinking about a change for yourself or a loved one, you will have to do a bit of research. Trusted resources like Area Agencies on Aging and your local senior center can help.

Please consider Health Alliance Medicare a resource, too.

We all want to make well-informed choices that don’t depend on myths and misinformation.