What are the most common questions about Medicare?
A big part of my job is helping someone understand the different parts of Medicare and how they all work together. Prescription drug coverage is also a big concern for many, and I help explain their Medicare options. The fact is people have a lot of options when choosing a Medicare plan, and that can be confusing—so I help them understand how to select a plan that best fits their situation.
What should they have ready when they call?
Have your Medicare card. You should receive your card 4 months in advance of your eligibility to enroll. If you’re on Medicaid, it helps to know what level of Medicaid you have. If you don’t know, we have resources that can help determine your level of eligibility.
How long does it take to enroll in a Medicare plan over the phone?
I normally spend anywhere between 10 minutes and 1 hour with a customer to ensure we cover all their questions. If you are new to Medicare, it might take a bit longer to cover all your needs and ensure you understand which plan is best suited for you.
Are there specific enrollment dates to be aware of?
You need to enroll during a time when you’re eligible.
Here are some examples of when you would be eligible:
- When you’re turning 65—you can enroll up to 3 months prior to turning 65, the month you turn 65 and then for another 3 months after. We recommend signing up prior to turning 65.
- You can also enroll in a Medicare Advantage plan during the Annual Election Period (AEP), which occurs from Oct. 15 through Dec. 7.
- You might qualify for a Special Election Period (SEP) if you meet certain conditions, such as losing coverage as a result of moving out of your plan’s service area.
- You may also qualify for a quarterly SEP if you’re dual eligible (you have Medicare and Medicaid) or if you have a low-income subsidy (LIS) to help you pay for prescription drugs.
What’s the biggest concern you address for your clients?
The biggest concern for most customers is keeping their primary care physician, so I help pinpoint plans that have their doctors in network. Sometimes their doctor won’t accept Humana, so I help them understand how a PPO plan or something similar would let them stay with their current doctor. To that point, if their doctor is part of an HMO plan, we help them understand whether the HMO could actually be a better fit for their needs.
If someone already has a plan with another carrier and wants to switch, is there anything specific they need to do?
My guidance would depend on their individual situation. Everyone is unique. This is why having a conversation is so important.
What plan benefits are consumers often unaware of or confused about?
One of the key benefits that consumers should know about is that they have a financial safety net, called the maximum out-of-pocket (MOOP). This helps protect the consumer from unexpected and often expensive events, like a hospital stay. Plus there are benefits included with some plans other than just healthcare—such as dental and vision coverage, coverage for certain transportation costs, an over-the-counter allowance, SilverSneakers® (a gym membership), chiropractic services and acupuncture.