This article is part of an ongoing series of informative Medicare guest posts written by MedicareFAQ. - Carol
Knowing the top 5 questions to ask your Medicare insurance agent helps you gain more control in the conversation. This also gives you more confidence in your ability to trust a stranger on the phone. Having a questionnaire ready before your meeting can also help you understand what to expect from the conversation as well as what to look for in an agent.
If you are new to Medicare, having policies change or drop coverage and seeing constant changes can be overwhelming. Trusting the person helping you make a better financial choice is key when obtaining coverage.
That's why Medicare beneficiaries can benefit from working with an agent that represents multiple companies. This leads me to the first question every beneficiary should ask the insurance agent on the other end of the line.
First Things, First: The first question any Medicare-eligible beneficiary should ask, right out of the gate is
1. What companies do you represent?
Working with an agent that only represents ONE company, you’re immediately limited to the one option. Additionally, it makes comparing all the top local plans more difficult. Working with an agent that represents multiple companies will make your life easier. These agents are known as brokers.
Brokers look at rates, companies and plans ALL DAY LONG! Trusting someone that has acquired this much experience should be easy.
However, it’s understandable that with phone scams, many seniors have been hesitant. Well, any licensed insurance agent has a “license to sell”; this means you can look up the licensed on the state insurance department website.
Agents also go through continuing education every year or two. So, if you’re lucky enough to work with a Medicare broker that has an active license in your state, ask them about the types of Medicare plans they sell.
2. What policies do you sell?
It’s important to ask your insurance agent: “Which types of policies do you sell?”
If you’re working with an agent that specializes in Medicare Supplements, they can still answer questions about Medicare Advantage plans.
Medicare Advantage plans can also be viewed online via Medicare’s official website.
However, getting rates for a Medigap plan requires that an agent be appointed by an insurance carrier to properly quote a potential beneficiary.
Although, if you’re more serious about a Medicare Replacement (Medicare Advantage) plan then you should talk to an agent that sells those policies.
Either way, knowing what your Medicare insurance agent sells will make it easier for you to get the information and compare plans.
It’ll also give you an idea on the direction of the consultation.
3. What are my out-of-pocket costs?
“What are my expected out of pocket costs?” seems like an obvious question, however, with some plans, you need to understand the potential risks.
So, with Medigap coverage, you can expect that if Medicare pays, the plan pays. However, when you select a Medicare Replacement plan the only thing protecting you from a 20-thousand-dollar medical bill is your maximum out of pocket (MOOP). The MOOP is the highest yearly amount you could spend on your healthcare.
So, if your Medicare Advantage plan has a 10-thousand-dollar MOOP, the most you can spend for the year is 10k on eligible expenses.
However, the national average for Medicare Supplement Plan F is only about $150 a month or $1,800 a year. This means, all the gaps in coverage are paid and no out of pocket expenses for you.
Medigap plans can offer beneficiaries peace of mind. Coverage stays the same every year; so, there’s no need to change plans annually. Additionally, those with comprehensive Medigap coverage don’t need to worry about unexpected out of pocket costs, ambulance rides, long hospital stays or surgery.
However, if you have a Medicare Advantage policy it’s important that you save money each month to use in case of an emergency. These out of pocket expenses can add up and the only way to protect yourself is to prepare.
By understanding any possible out of pocket expenses, you’ll create better peace of mind.
4. Ask every question on every topic that confuses you
I can’t stress this enough; writing your questions down as you have them will make your life so much easier!
Insurance agents expect you to be confused and need assistance. So, ask all the questions you have about Medicare, Medicare Supplements or Medicare Advantage plans. Ask about drug coverage and ancillary benefits.
Be sure your doctor is covered, as well as your specialists. Even ask about your pharmacy, because Part D plans have pharmacy networks; you shouldn’t pay more for the same prescription.
Some Part D plans even have mail order pharmacy savings, ask about those benefits. There are some drugs beneficiaries are getting for $0 because they receive mail order savings.
5. How Do I Enroll?
Once you’ve asked all the questions, checked all the options and made your final decision; you’re ready to enroll. The process is simple and can be done over the phone.
Your agent will rejoice when you ask, “How do I enroll”?
The licensed insurance broker can walk you through the enrollment process in just a few minutes. If you have your Medicare claim number and your date of birth, you’re ready to get started.
Beneficiaries new to Medicare will benefit from the Medicare Supplement Open Enrollment Period. This offers you Guaranteed Issue rights on a Medigap plan, so, you don’t need medical underwriting. No matter your health issue you get the best coverage at the best price.
Don’t delay enrollment. This is especially important for Part D because you don’t want to be responsible for the Part D late enrollment penalty.
If you miss the Initial Enrollment Period, you’ll need to wait for the Annual Election Period. Call an agent today, ask all your questions and get the coverage you deserve.