Medicare - Success Stories
Tony was new to Medicare when he reached his 65th birthday. Previously he was on an individual health insurance plan with premiums of about 2,500 per month. That plan had a high deductible with copays. Tony was seeing a total of 8 doctors and specialists. His list of prescription drugs was significant too. He needed a quality health plan with a strong network of doctors and hospitals. Although he lives in an area where several quality Medicare Advantage plans with rich networks are available, none of which included all his doctors. Their prescription drug formularies either excluded the brand of prescription drug he preferred, or the out-of-pocket cost would have been unreasonable.
Tony decided to use his original Medicare benefits and enroll in a Medicare supplement plan. This way he could see any doctor or go to any hospital or facility that accepts Medicare. He would never have to obtain a referral to see a doctor or specialist. It was also important that he enrolled in the Supplement plan during his guaranteed acceptance period due his health conditions which could prevent him from enrolling in the future. As a Medicare Supplement plan member he required a separate standalone prescription drug plan. Each year during annual open enrollment Tony can shop other prescription drug plans that meet his current needs while he keeps his guaranteed Medicare Supplement plan active.
Needless to say his plan premiums dropped significantly and now his out of pocket cost for healthcare have a lower and much more friendly maximum. Lower cost and better benefits are a great combination.
We talk each year to be sure his plans continue to meet his needs.
Kelly had been a Medicare Advantage plan member for 5 years when we first met. She is a wonderful lady is good health. Good health at 70+ typically means you are managing just a minor health condition or two. Her budget was tight and could not be stretched any further.
I asked her what she would like to change about her health plan and she quickly mentioned a primary care doctor she had years back that she was in love with. He had stopped providing primary care services to practice in a hospital and couldn’t be her personal doctor.
As it turned out when I did my search for plans, I learned the doctor she wanted was now a primary care doctor in a local Medicare Advantage plan network. He was accepting new patients.
Based on her good health conditions and limited prescription drug usage we were able to enroll her in a plan that also offered a Medicare part B premium rebate.
She has been in this plan for several years now, we review benefits each year to be sure they continue to meet her needs. Each time we meet she hugs me and tells me how happy she is with her Medicare Advantage Plan.
We are all different, we are in different situations and have different priorities and different resources. These examples are here to provide a general picture of the ways we help others protect their family and provide for their family over the long term. Insurance is forward looking and when applied properly, a very valuable tool.
We look forward to hearing your story and providing you with options that help you protect and prosper.
Richard Schimmenti and Harbor Ridge Financial is an Independent Broker/Agency, however we do NOT offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or call 1-800-MEDICARE to get information on all your options.