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5 Surprising Things I’ve Learned About Medicare (#3 Sound Familiar?)

When you work and live in the space of any profession – day in and day out – you tend to learn your craft pretty well! That’s how it is with me and my team when it comes to Medicare.

This month, I thought I’d share some of the top things we’ve learned over the years. Some you’ll know very well; some might be things you hadn’t thought of yet.

People Learn About Medicare by Word of Mouth

Medicare “education” is much like the game of telephone you played as a child. Remember playing? A phrase is whispered into kid #1’s ear. They relay what they hear to kid #2, and so on. The last kid quite often hears something very far off from the phrase whispered into that original ear!

Well, that is definitely how people gain much of their Medicare knowledge, and it can be detrimental to their experience. We often hear, “I signed up for Medicare’s Part B because my sister told me that I needed to. She’s older than me so I assumed that she was right.” Ouch.

Why does this occur so consistently? We believe that it can be largely attributed to our insurance industry’s sales tactics. When people are approaching Medicare eligibility, they are incessantly pestered with post cards, sales calls, robocalls, and a number of solicitations from so many sources.

So, what do many people do? They shut down and listen to their inner circle. Friends, family, colleagues – where advice often results in decisions made via the game of telephone!

Medicare Stresses People Out Immensely

One of the things we hear at the end of our consultation process with a new client is, “Wow, that really wasn’t that bad.”

Our clients are people that have worked for 40 years. In that time, their insurance plans had largely been selected for them, and each year they were presented with one to three options at their workplace during open enrollment. They would simply choose one and move on.

Because of this basic process, many have not had to face selections that could last for 25 years in retirement. Selections that can adversely affect them for the rest of their life. Selections that don’t just get that “do-over” every fall.

They hear stories about who did what and what happened where, and they realize that they are 65+ and health issues can move to the forefront in their worlds. That’s where the stress factor builds up.

Medicare doesn’t have to nor should be stressful. We say that “Medicare is easy when you do the right thing at the right time; you just need to know what and when.” That’s what we’re here for.

Think of learning about Medicare as a process – it takes time. A great source to begin with, if you are 6–12 months ahead of your decision making with Medicare, is our “pre-conversation” package. Basically, it covers all the biggest nuggets about Medicare without the need of a PhD in the topic.

People Want to Know if They’re Doing Something Wrong

Generally speaking, no one wants to sign up for Medicare and later learn what they did was wrong. That they were missing a piece of extremely important information. Or, that they chose the wrong product that could hurt their world of health insurance. All because they didn’t know enough.

Here’s an example. A fellow came to a Medicare session of mine recently, saying, “This is the fifth session about Medicare that I’ve been to, and I never really understood that there are two product choices.”

My first thought was, “That is really rotten that you have to attend five Medicare sessions.” I can’t imagine that he enjoyed spending his time doing that! But going to different agents meant he was onto something.

What was he seeking? He was seeking a nugget of information that was clearly missing. Because yes, knowing that there are two product types to choose alongside Medicare is a giant nugget.

Be sure to ask your agent about your two choices. If they present you with only one or you feel pressured, thank them nicely and make another phone call.

Pre-Existing Conditions Are a Big Deal with Medicare Coverage

We’ve all grown up with the ACA (Affordable Care Act) in our rearview mirror. Pre-existing conditions don’t count against you as you sign up for your insurance coverage when you are under 65.

Why would you not assume that this policy carriers over to Medicare? Well, it does not.

Working with people, we are consistently hearing tidbits about their health status. Some people are private about it; others are not.

When we do learn that a person has or is struggling with a major illness (think cancer, MS, dementia, and more) we are a bit extra, extra firm in our recommendation as to coverage. You must understand what you are purchasing.

When someone is brand new to their Medicare Part B coverage, they have the right to purchase a Medigap contract within their first six months with no pre-existing conditions handicapping their product choice. A carrier cannot deny their enrollment.

After that? Aside from a couple of small loopholes, the person may not or will not be accepted by the carrier for a Medigap plan.

This is often shocking to people. We hear “I had no idea; no one told me that; I thought that there were no pre-existing conditions anymore.” We have to deliver the bad news.

People Simply Want Help When It Comes to Medicare

In today’s world of phone trees, services routed to third party vendors, and the confusion of the Medicare topic, people are looking for guidance. They simply want someone to help them make the right choice.

Our specialty is transitioning those from the private sector insurance over to the Medicare system. Basically, we walk people through “how to sign up for Medicare” and the dozen core questions that revolve around that.

There’s often a disconnect in the world that tells you to “go sign up and come back to buy a product.” What about the how? The process, the selections, the information…? Much is lacking, but we are committed to cast some clarity on the Medicare system.

Thus, we do what we do!

How often do your Medicare questions remain unanswered? Have you had a session with a “professional” that created more confusion than clarification? How did you learn which Medicare plan was best in your situation? Please share your experience and stories with the community!

Please take the Sixty and Me 2023 Community Survey

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The Author

Joanne and her team have built Giardini Medicare (formerly Boomer Health Group) https://www.gmedicareteam.com/ to provide consumers with Medicare help. They work within an industry full of unclear information and much noise (designed to confuse very intelligent people?) and are received as a breath of fresh air. Contact them with questions at info@gmedicareteam.com.

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