My agency has long focused on working with senior citizens as they approach Medicare age, mainly by offering Ohio Medicare Supplements. We’re known for our informative, consultative approach. We explain what plans are available and help people pick one that best suits them. We’re also well versed in explaining how all the pieces of Medicare fit together. So all things considered, we’re a pretty good resource.
But, we certainly don’t get to talk to everyone who reaches Medicare age. And when those people call or drop by because they’ve got problems or questions, we hear some heart-wrenching stories. When “Mr. I’m an out of town salesman who doesn’t give a crap about you” swoops in and signs up a Medicare-eligible person for their “super-duper” plan, we get to pick up the pieces. We take the phone calls from those Medicare-eligible folks who wonder why their plan doesn’t work around here or why Mr. Salesman isn’t returning their calls. And the worst part is when we can’t help- especially when guaranteed enrollment periods have passed and/or they’re stuck paying for something they can’t use.
So, my goal here is give people the facts. Slick salespeople may try to convince you these things don’t matter, but they’re WRONG. These are written down, hardcore facts. Insurance “gospel” if you will. So take this to heart. And share with those you love so they can avoid heartache. Here’s the 5 most common Ohio Medicare Supplement scams you need to watch for.
Medicare Supplement Scam #1
My Super Duper Medicare Supplement Plan G is better than that other company’s Plan G.
Wrong. Medicare Supplement plans were originally standardized in 1992, with some additional re-standardization occurring later. At the time of this writing, the following plans are available in Ohio: A, B, D, G, K, L, M and N (plans C and F are ONLY available for those reached Medicare eligibility before 2020).
By law, plan benefits must remain the same from company to company. So Plan G with one company is the EXACT same plan with another company.
What CAN differ? Administrative details such as premiums, method of premium payment, claims submission and treatment of pre-existing conditions. But what CANNOT differ is the plan benefits. It’s the law. So, if a salesperson tells you this, tell ’em to go fly a kite.
Medicare Supplement Scam #2
The Medicare Supplement open enrollment period is no big deal- if you miss it, don’t worry about it.
UGHHHHH…. Yes, it is a big deal and here’s why: you are guaranteed a Medicare Supplement within 6 months of enrolling in Medicare Part B. What if you have a major medical condition like cancer, stroke or heart attack? Doesn’t matter- a company can’t turn you down if you’re applying in that six month time period.
But, what if you enroll after your guaranteed enrollment period? Then a company can say “NO” to your application, meaning no coverage. I would consider that a big deal, wouldn’t you? And if the salesman says it isn’t, show ’em the door.
Medicare Supplement Scam #3
If in the future you want to switch plans, you can jump from Medicare Supplement to Medicare Supplement without any trouble.
Just like Scam #2, this is a big deal too. Once your guaranteed enrollment period is over, you will be subject to medical questions on the application.
So if you decide you don’t care for Company X or think their premiums are too high and want to switch to Company Y, you WILL be required to complete an application and answer medical questions.
Company Y will review the application and either say Yes or No. And if you’ve already canceled the Supplement with Company X? You’re probably out of luck. And would probably have to complete a new application again.
Medicare Supplement Scam #4
Medicare Advantage plans are the best option versus Traditional Medicare + a Medicare Supplement.
It depends. Medicare Advantage plans were introduced many years ago and actually take the place of original Medicare. They are similar to health insurance under age 65 in that you may have deductibles, co-pays, drug coverage, etc. Premiums for Advantage plans are typically less because the plan requires you to see medical providers within a certain provider network to get coverage.
In smaller areas, Advantage plans may not be a good option. Why? Because the provider network is also smaller. But agents selling Advantage plans can make big bucks off each sale as opposed to making a small percentage off a Medicare Supplement. And if that agent never has to see the person again, where’s the incentive to do what’s right?
I can’t stress this enough– if a salesperson suggests an Advantage plan- check the provider network first. If your local hospital and doctor aren’t in the network, then it’s probably not a good fit for you. And if a salesman says otherwise, walk ’em to the door and say “Thanks, but no thanks.”
But you say……”the premium is $0! How can I not do this?” My response is, “What if you have to pay for your doctor visit or hospital stay completely out of your own pocket? Do you think that $0 premium was actually a bargain?”
If you’re in a metropolitan area, an Advantage plan may make sense. But do your homework first and see if the doctors and hospitals you go to are covered. Then if it looks good, check out the rest of the plan benefits.
Medicare Supplement Scam #5
If you’re on original Medicare, and involuntarily lose your group, retiree or union health coverage, you’ve got plenty of time to choose a Medicare Supplement and be guaranteed to get it.
This type of situation is extremely time-sensitive. You have no later than 63 calendar days after the latest of these 3 dates:
- Date the coverage ends.
- Date on the notice you get telling you that coverage is ending (if you get one).
- Date on a claim denial, if this is the only way you know that your coverage ended.
Guaranteed issue means the same thing as above- no health questions, no underwriting. You fill out the application and pay the premium and you get it.
You miss the 63 days and you will no longer be eligible for guaranteed issue.