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Choosing the Right Medicare Plan


Local News 8: Thank you, Jeff. It is now 644. You can also learn something here with us and Lee Wilson from his joining us this morning from Teton Medicare to answer some of our questions and get some answers. And one question I have. First off, I wanted to ask, you know, sometimes you hear people might say, well, doesn’t Medicare cover someone enough? So why is more coverage needed? 

Lee Wilson: Great question. So yeah, Medicare does not cover everything people assume. If I’ve got Medicare, I’m set. I’m good. Not necessarily. So with Medicare, there’s large deductibles. Every time you go to a hospital, you’re paying 20% for every doctor, clinic, treatment, follow up, etc. no drug coverage. And perhaps the biggest risk with Medicare by itself, there’s no maximum out-of-pocket, which means you’ve got medical bills that can keep piling up for forever. We don’t love that. Right? So that’s what we do is help people look and compare Medicare supplements and Medicare Advantage plans. Today, I want to focus more on Medicare supplements, which a Medicare supplement, also known as a medigap policy, two terms for the exact same thing. It’s a secondary policy offered through an insurance company to help fill those gaps. It helps pay that hospital deductible. It helps pay for those doctor’s bills and clinics and follow ups and whatnot. Some of them pay almost the entire thing. So kind of nice. But there are different supplements depending on the coverage that people need and the budget that people have to spend. 

Local News 8: All right. can you change the Medicare supplement? if you need to.

Lee Wilson: Yes. So Medicare supplements, generally you can change actually anytime during the year. You’d normally have to apply to change, which means they ask you some health questions. They can approve you or deny you. However one change big change for your viewers who have Medicare supplements here. A couple of years ago, Idaho adopted what’s called the birthday rule, which means every year if someone’s on a Medicare supplement, they have a 63 day window following their birthday. Specifically where regardless of medical health, history, whatever else, medications they can change from one supplement to another for either, you know, different coverage or lower costs, no questions asked. So no underwriting is guaranteed

Local News 8: except in your own personal little enrollment period. 

Lee Wilson: Exactly right. So it’s different for everybody based on your birthday on the Medicare supplement specifically. But that’s a great time to review, to make sure you’re not overpaying for a Medicare supplement. 

Local News 8: So if you need to make a change, you have to see a doctor first or no, not usually. 

Lee Wilson: No, no doctors are needed. and one question we have regarding doctors a lot is can I see anyone with a Medicare supplement? Technically, no. Close. But you still have to go to doctors and clinics and accept Medicare. So sometimes people come in and say, I can go anywhere I want. Well, almost that doctor’s still have to accept Medicare as the primary insurance. As long as they do, then that Medicare supplement will be accepted and cover really well. 

Local News 8: So let’s compare, Medicare supplements. Are they better than advantage plans or what’s the comparison? 

Lee Wilson: Very common question I get asked every day. Is a Medicare supplement better than the Medicare Advantage plan? Which one? Which one should I go with. And the answer is they’re both fantastic plans. Frankly, I wish I could get either one. I’m stuck on Obamacare for another 20 years. They’re both great plans. It just depends on what people are looking for. There are pros and cons to each, but again, it’s important to talk to an independent broker like Teton Medicare. We can say here’s exactly how they work, how they compare, what they cost. What are your needs Dylan versus anybody else. Right. So that’s kind of how we help people know really what’s what and make sure they get the retirement right and the best coverage for them. 

Local News 8: All right. Excellent. Answers better than YouTube. All right. Thank you for your time. All right. Let’s take a peek outside.

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