Over 50% of Seniors Say the Medicare Process is Confusing

Wednesday, October 03, 2018

More than 50% of seniors enrolling in Medicare during Open Enrollment find choosing the right plan confusing. With over 35% of seniors, not prepared to choose a plan that is right for them. 

Add in the process of choosing a supplemental plan, to cover some of Medicare's "gaps" like co-payments, deductibles and other out-of-pocket costs and now it's even more daunting.

Additional coverage like Medigap, is private health insurance designed to supplement Medicare by paying for some of the gaps.  A Medigap policy can help you pay for fees and services that Medicare doesn’t cover.

No joke – the gaps in Medicare are sometimes big enough to drive a truck through.  For instance, there is a long list of routine exams and services that Medicare either doesn’t cover or doesn’t cover completely.  And, with Medicare, you are still responsible for deductibles and co-insurance.  These may seem like small amounts until you have an illness, and then “WHAM!”  Those costs can run up your health expenses very quickly.

Hospital admission costs continue to rise.  If you have a hospital stay, you’ll pay a big chunk for the first day and then you’ll pay out-of-pocket costs for each subsequent day.  Gaps in coverage for physician services can also add up too.  You’ll pay an annual deductible, a copayment for each service, and you might also have to pay a portion of the service charge that Medicare doesn’t cover. 

Some doctors accept Medicare assignment.  That means they will take whatever Medicare pays for a service.  They will not come back to you for additional payment above the approved Medicare amount. So, as part of your research, contact your current doctors and those within comfortable traveling distance to see whether they accept what Medicare pays.  You’ll want a doctor you can trust that also has reasonable fees. 

It’s pretty clear that it makes sense to find insurance that will help you pay some of the costs Medicare doesn’t pay.  But, finding the right insurance can be a daunting task.  The things you have to consider can be complex and the literature that’s available is confusing.  Many people just walk away feeling bewildered.  Ultimately, many people select plans that don’t have the benefits they need or they pay more than they should for those benefits.  Don’t be one of them.  You can find cost effective benefits, if you do some comparison shopping.  

Still, there are no easy rules for choosing a Medigap policy.  That’s because everyone’s needs something different.  So, first you need to think about what is important to you.  Consider the level of benefits you want and how much you are willing to pay. 

Take into consideration your current health and your future health expectations.  But, even if you live a healthy lifestyle, there is no guarantee that you’ll stay healthy. There are hereditary and environmental factors you just can’t control.  So, make sure to plan for some unforeseen possibilities, just in case.

Also consider any other insurance you have that will continue after you reach age 65. Often employers or unions will provide some healthcare benefits.  You’ll want to make sure you really do need additional coverage.  If you decide that you do, look for a policy that will cover different services – rather than duplicate the coverage you already have.

Don’t depend on one insurance agent to give you comprehensive information on plans that are available. They can’t!  They only know about the plans they sell for the companies they represent.  Even independent agents generally represent only a few companies.  So, go ahead and ask.  This way you’ll have a better understanding of the information you’re getting and how it fits into the bigger picture.

The same is true for insurance quotes you see on the internet — take a look at the number and names of the companies they represent. You’ll notice some sites will tell you and some won’t.  That’s because they are designed to funnel you to a plan they want to sell, not give you the full gamut of available choices.  You can still gather some information from these tools, but remember you are only getting a very small view of the plans that may be available to you.        

So, finding the best benefits at the best price isn’t usually a one-stop shopping experience.  But, it does pay to find as much price comparison information as you can, because prices do vary — a lot.  And it’s very possible you can find the same benefits for less, if you shop around. 

So, to avoid getting ripped off, be very careful when evaluating your Medigap options. You may also want to consider our personalized Medigap Report. It offers a complete list of nearly all insurance carriers in your area and what they are offering you right now for EACH Medigap plan. That data is based on your personal circumstances — age, gender, and zip code — and the report also provides each insurer’s Weiss Rating.

For a very reasonable price, it could ultimately save you thousands of dollars in unnecessary premiums. Be sure to always consult Weiss Ratings on the safety of the insurer underwriting any plan, too.

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