Medicare and what?

I signed up for Medicare when I turned 65, looking forward to spending hundreds of dollars less for good medical care. But figuring out the options wasn’t that simple because everyone and his brother wants to sell you gap insurance to make up the difference between what Medicare pays and what the costs actually are. If you’re not careful when you’re researching, you end up giving permission for everyone to call and text you to hard sell you on their insurance.

I’m a librarian and I love to research – and I also read the fine print so I didn’t sign up with any of those people. Instead, I contacted an insurance agent who specializes in medical insurance. We discussed how it worked and she sent me information about 52 different policies that all covered Plan G (my chosen option) in Texas. At her suggestion, I talked with my doctors to find out if they had companies that they did or didn’t find easy to work with. They all strongly did not like United Health Care or Medicare Advantage plans, so I steered clear of them. I signed up for Original Medicare + Plan G gap coverage from Mutual of Omaha + Part D (prescription) coverage from Wellcare. I’ve had no regrets.

The case manager at my first rehab facility told me that my choice of coverage made things easy for him – and for me – to get additional care, and that I had the “Gold Standard” of coverage. He hates Medicare Advantage plans because, although they are cheaper and cover things like dental and eye care, they make it harder for a patient to get more therapy because insurance wouldn’t cover it or would make it harder for the providers to get paid. My coverage (Original Medicare + Mutual of Omaha) fully covers 100 days of additional therapy. He really hates Joe Namath and the others who do commercials for Medicare Advantage plans because they persuade people to sign up without really researching long-term complicated coverage questions.

So if you’re approaching Medicare insurance time, do your homework. Don’t just look at the monthly fee. Look at the coverage, talk to doctors’ offices (I talked to the finance office), and go to an insurance agent who represents many companies and not just one. If an Advantage plan is financially best for you, fine. But ask lots of questions about complicated health condition situations – like the need for long-term therapy.