Enrolling into Medicare is one of the most complicated endeavors you go through as you prepare to turn 65. Thankfully, independent insurance agents make the confusing process simple.
Independent agents who focus on Medicare and senior-related products have been likely coaching up their clients on the process for years – even decades.
But when it's time to enroll in Medicare yourself, you get a whole new feel for what it's really like to go onto government healthcare.
We pestered some of our awesome post-65 agents and asked them: what surprised you about enrolling in Medicare?
Many said that nothing shocked them, but for some, they were in for some real surprises, and their experiences range from thrilling to frustrating.
Kris H. explains that the amount of paperwork involved is pretty ridiculous.
"My husband had a preventive colonoscopy, and we received 13 statements for that ONE procedure – and they were all identical," she explains.
Turns out Kris isn't the only one who thinks Medicare is wasting some serious paper...
Janet J. says she finally understands the frustration with Medicare mail.
"I used to be astounded when clients would say they didn't open a lot of their mail, but now I get it. It seems as though we get a ton of repetitive mailings and it does become tempting to just pitch it," she says.
The worst part? Most of the mail is seemingly useless. Come on, Medicare! Save the trees!
Everyone's experience is going to be different depending on where they live, and while we know from research that over 90% of doctors accept Medicare, Bill M.'s experience was a bit different.
"A lot of specialists and dentists do not take Medicare," he says.
What Bill is talking about isn't regular dental work, which of course isn't covered by Medicare. It's the medically necessary work – like the tumor he found out he had above the roof of his mouth.
"They numbed it, cut it open, and scraped the tumor out. A dentist had to do it, and that kind of thing is covered under Medicare. However, that dentist didn't accept Medicare."
He also found that many of the cancer doctors in his area don't take Medicare. Their reasoning? They don't get paid enough.
What really surprised Holly H. when she first got onto Medicare was actually a mistake made by her local Social Security office.
"I had good insurance coverage when I turned 65, so I delayed signing up for Part B. When the time came, I was told I'd have to pay a Part B penalty or I could pay the back premiums from when I turned 65."
The total she'd owe according to this Social Security representative at her local SS office? Nearly $2,000. And he wanted her to sign a paper saying she agreed to the charge.
Being an agent, Holly knew this wasn't correct, but it was still concerning to say the least.
"I did eventually get it straightened out, but it was very disheartening to be given the wrong information," she says.
"I found out that being your own health advocate is an almost full time job," Kris H. explains.
In her experience, the left hand doesn't know what the right hand is doing when it comes to things like late enrollment penalties, other primary coverage, etc.
Kris explains that Medicare often sends inaccurate letters, such as a plan leaving a service area when it's not really the case, letters saying a client moved counties and it's effecting their plan when they haven't moved in the last 30 years, and other frustrating situations like this.
"I think Medicare is a great program... it's just the bureaucracies that get in the way of it being effective," she says.
"This was a surprise to me," says Bill M. "I always thought Plan G was the best because it was the best value, but the paperwork... it's just not worth the $10 a month you save compared to an F."
Bill explains that this year, he went to 3 different doctors and had deductibles at each office.
"Everything drags out 2-3 months, so you have to mine your Medicare statements with your Medicare Supplement statements to see how much deductible you've paid at which place... it's a hassle," he explains.
Since Medicare pays so slowly, the provider sends multiple statements that all say the same thing, and it's just downright confusing.
Bill says that once you get to be his age, things get more difficult. Looking back, the Plan F would've been worth the extra premium to get rid of the hassle.
"I now tell my clients my own experience and some still choose the G, but to me, it's a no brainer," he explains.
While Medicare does seem like quite the pain at this point, it's not all bad!
Harry K. explains that nothing really surprised him about Medicare other than how completely thrilled he has been with the breadth and depth of the coverage.
"Neither I nor my wife ever worked for a big company with generously robust benefits. I've never had coverage like this in my entire life!" he says.
Harry explains that while he hasn't had any major medical emergencies, one of his clients went in for what was supposed to be a quick "tweak" to his heart to correct a shortness of breath issue.
The quick visit turned into a 3.5 month hospital stay due to a severe allergic reaction to the anesthesia. Over $1 million was spent to keep him alive and get him back home, but with Medicare and a Plan F? He wasn't billed for a single penny.
"That's how incredible Medicare coverage is," Harry says.
While many agents did experiences some surprises, others like Andrea B. didn't.
"I don’t think there were any great surprises with this milestone in my life, but it’s nice to be able to say to a new client that I’ve personally experienced something. It gives them confidence in me to know I’ve survived and even thrived through the process," she explains.
Andrea says she now understands the online enrollment process – which is pretty simple, by the way – and also how long things seem to take.
"I paid my first payment quarterly, then submitted the automatic payment form about a month later. It took almost 6 months for all of that to reconcile itself," she recalls.
This is all personal experience that she can now relay to her clients, which is pretty reassuring.
Whether you're an agent right out of college or you're a few years away from Medicare yourself, hopefully these insights from post-65 Medicare agents can help you out.
If you have your own stories or experiences with Medicare, leave them in the comment section below!
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