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What Your Broker Wants You to Know

A broker is a third party liason between you and your health insurance carrier. Many brokers do not charge any type of fee for their services as commission is already part of the rate you pay. You will not pay more by working with a broker. However, there are many benefits. In navigating Medicare, it is helpful to have an expert on your side. There are many things your broker wants you to know about Medicare.

Defer Part B

You can and should defer Medicare part B if you are working past the age of 65. Many people are putting off retirement until a later age. If you are working past the age of 65 and receiving creditable through your employer, you should defer Medicare Part B.

There is a premium for Medicare Part B. If you currently have health insurance through your employer, there is no need to pay twice.

When choosing to defer Part B, make sure to follow the instructions on the back of the card and send it back. If you keep the card, you will keep Medicare Part B and you will be charged for it.

There is an added bonus to deferring Part B. If you choose to enroll in a Medicare Supplement Plan, your best bet is to enroll during your IEP. This is the 6 months after you turn 65 and enroll in Medicare Part B. During this time, you will not be subject to medical underwriting. If you wait past this point you may be subject to medical underwriting. You could therefore be charged more or denied outright.

Review Your Plan Every Year (Ideally with Your Broker!)

If you choose a Medicare Part D plan or Medicare Advantage, make sure to review your plan every year during the AEP (ideally with your broker). Benefits and networks and prices can change. You don’t want to be roped into a plan that no longer meets your needs or is too expensive. It’s also a good idea to review other available plans as there may be a new one better suited to your needs.

Proceed with Caution for Medicare Advantage

Many Medicare Advantage Plans advertise themselves as “free”. They claim to offer additional benefits not offered by Original Medicare. These are benefits such as dental, vision, hearing, prescription drug and more. These claims are misleading. A good broker will inform you of this.

At the very least you will still have to pay for Medicare Part B. Remember, these additional benefits come at a cost. You are giving up the ability to see almost any doctor and use almost any hospital. 

This is very important. Many people enroll in a Medicare Advantage Plan and are then unable to find doctors, hospitals, and specialists within a suitable driving distance. Of course, this is certainly not always the case. Many people are well served by their Medicare Advantage plans. Your broker can advise you of your best options.

Nursing Homes are Not the Same as Long Term Care

Medicare Part A covers skilled nursing facility care. This is not the same as any type of long term or custodial care. These types of facilities are designed for recovery or rehabilitation after hospitalization. If you have any type of long term condition or if the treatment of your condition does not require skilled medical care, Medicare will not cover it. For example, Alzheimers is a long term condition and would not qualify you skilled nursing facility.

Also, if you have had care in a hospital and need care such as help eating or getting dressed, even if this is as a result to your hospitalization, you would not qualify for SNF without the need for skilled medical treatment. If you need assistance part time, you might, however, qualify for home health care. 

Medigap Plans Don’t Have Networks

If you choose to purchase a Medigap Plans you may see many familiar big name carriers like Aetna, United, Humana, etc… you may be inclined to purchase a plan with a familiar carrier. 

However, regardless of who your carrier is, if your doctor accepts Medicare, they will accept your supplement plan. So, it doesn’t really matter who your carrier is as long as they have a history of low and stable premium increases. A broker can help you with this.

Owner and CEO of Smedley Insurance Group, Inc. at iHealthBrokers | Smedley Insurance Group, Inc. | Website | + posts

Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.

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