April 1, 2022

Case Study - Choosing A Medicare Plan

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Last month I met with a couple, Bill was 62 and Sally was turning 65.  They were interested in getting the right coverage based on their needs.  In this case, he was on Medicare Disability and she was turning 65 next month.  They wanted to explore their options for Medicare plans.

Let’s look at Sally’s needs first:

For Sally, she wanted to know how seeing a primary care doctor was covered and if any labs or x-rays taken during the doctor’s office would be covered.  So we explored two scenarios.

Option 1:  If she enrolls in a Medicare Part C Advantage plan which are offered by private insurance companies, some plans will cover the cost of the x-rays / labs with the co-pay for the doctor’s visit.  Other companies will have a separate charge in addition to the doctor’s visit co-pay.   As we reviewed the various plans there were many details that outlined the differences between private companies that offer Part C Advantage plans.  Premiums for Part C plans range from zero dollars ($0) to over $80 / month and in most cases include a prescription drug plan.

Option 2:  If she enrolls in a supplement MediGAP plan, like plan G, she will have a one time calendar year Part B deductible under $225 after which she will never see another bill for any Medicare approved services.  The deductible only applies to services outside the hospital.  The MediGAP plan pays for the Part A hospital deductible which is over $1,400.  Additionally, if she goes with the MediGAP plan she will need a separate stand-alone drug plan.  Premiums for a MediGAP plan at age 65 will be around $130 and the prescription drug plan (PDP) will range from $7 to over $40 / mo.

She decided to go with the MediGAP option.  Her premiums were $127 / month for the MediGAP plan G and $14 for the prescription drug plan.

Bill’s needs were different, so let’s take a look at the needs he has:

Bill is legally blind ,which is why he is on Medicare at age 62, and other than that he is in great health.  We reviewed the options between a Part C Advantage plan and a MediGAP plan coupled with a prescription drug plan.

He learned that there are several Advantage plans with a zero premium ($0) to choose from.  Since his health is generally very good, he decided to go with an Advantage plan.  I checked to verify that his doctors were in the network for the plan he wanted, and his mind was made up.  He chose one of the zero premiums ($0) Part C Advantage plans.

In conclusion, Bill & Sally chose to go with two different plans based on their individual benefit needs.   There were other variables that we did review for each of these options.

They also knew that there was no charge to meet with me to review their options in this selection process.   At the conclusion of our meeting, their applications were finalized.

Oakland Solutions (Computer Services):

I have the opportunity to meet with many people in many professions.  Dave Webber is a friend of mine and helps people and businesses with:

1) Virus Removal from your computer or network.

2) Wireless Networking installation & troubleshooting.

3) Identity Protection on your computer.

If you need to call on someone for any of these services give David Webber an email (Click Here).  Or you can click on his web site (Click Here) to see more.  He guarantees his work and is an essential business (open during CV-19).

Oak Crest Insurance Services, an Essential Business

We are open.  Here at Oak Crest Insurance Services we provide health insurance products by representing a number of insurance companies.  According to the state of Michigan, we are an essential business.  We are saddened by the pandemic that we are all experiencing.

Our role during this time as an essential business is to provide and educate people on health insurance products that will limit their financial exposure in the event of a medical event, help people to get a plan with benefits that fit their needs and do so while helping our clients keep more money in their own pockets.  We are open.  Additionally, people need to know that there are options other than COBRA which will reduce health insurance premiums significantly.

About the Author:  David Banet is a Licensed Insurance Counselor (Health & Life) and licensed in life, property and casualty insurance that helps people and small businesses with their health, life, business and retirement needs with insurance products. He has written over 100 articles on insurance. David is a family man residing in southeast Michigan, and is licensed in Michigan, Ohio, Florida, Illinois, Indiana, Pennsylvania and Tennessee.

He is an independent broker which means that he represents many insurance carriers. There is no charge to enroll in a health insurance plan for his services.  

David has given several educational seminars on Medicare Basics in the neighboring community.