The confusion continues in the Medicare world. Consumers at a rate of over 10,000 a day agent into Medicare and are bewildered at the options they face. In this article I aim to clear some mud related to some pieces of advice that are given out by people who might have bias or at best one sided information.
I’ll start by saying, I am an agent, and I do have bias. My bias is, whatever you pick, use my agency and our agents to do it. However, as far as picking between Medicare Advantage, Medicare Supplement, Part D Prescription Drug Plans, UnitedHealthcare, Humana, Aetna, Wellcare, etc, I am not biased. We have over 100,000 clients nationally, and at that rate, each product or even a satisfied customer we tell to keep a group retiree plan and make no commission on, has massive value to us. Our value is in the satisfied customer. So there is my disclosure. If you use us to purchase a product, most likely there will be a commission paid by the company we use. Why are we less biased than some of the people or groups I will expose? Because we won’t you to use us, not to buy one type of plan over another. The groups that I will talk about are worried about singular issues within your Medicare coverage rather than the broad topic of what is most likely going to fit your budget, risk tolerance, travel needs, and more.
Rural Home Healthcare and Skilled Nursing Staff
The first group I want to talk about is probably the loudest on Social Media. As someone who advises tens of thousands of independent agents and brokers around the country and represents thousands of Medicare beneficiaries, I get sent screenshots of text messages, Facebook posts and TikTok videos about Medicare Advantage quite frequently. This happens even more in or near the Annual Enrollment Period. 95% of the time these Social Media posts are from Home Healthcare Nurses or a billing manager of some sort with a Skilled Nursing Care organization in a rural area.
Now, the first thing I want to get across to you is that their beef is with Medicare Advantage, and it comes with a history of issues they’re carrying with them. Though Medicare Advantage plans have made great strides at improving billing and networks over the years, the biggest black hole we see still is Home Healthcare and Skilled Nursing Care. It is not that these plans do not cover these services, but more that they hold the services accountable for proving that the services they are rendering are medically necessary. Unfortunately, Traditional Medicare Parts A and B has been very lenient with these organizations on approving long term stays and long term home healthcare, and with Medicare Advantage, they are blindsided by the amount of information and detail they have to provide to get their patient’s care approved. The conundrum here is that while the scrutiny is likely better in the long term for our Federal Medicare budget, anytime someone’s job is made harder by something, they reject it. It is also possible that in many cases these plans have had poor processes for Prior Authorization and denied services for not getting the right information when those services might have been needed.
There is good news here. Medicare Advantage plans have officially been put on notice that in 2024 they have to significantly reduce Prior Authorization Requests and Denials. Most carriers have committed to have 20+% less denials in 2024. This should impact Skilled Nursing and Home Healthcare positively.
Lastly, I will say that the outlandish posts we have seen from these HHC and SNF nurses are normally riddled with misinformation. They’re attacking one small aspect of care overall and in the process say things like “Medicare is Full Coverage” and “Medicare Advantage has High Deductibles”, both of which are absolutely untrue statements. Recommendation? Talk to someone who has a track record of exploring all angles of coverage and helping you decide what’s best for your needs.
Medicare Supplement Only Agents on YouTube
Along the same line of gross negligence we see from the previous group’s misinformation as it relates to Medicare Advantage, there are a group of agents on YouTube mostly that make wild videos like “Why I would Never Choose a Medicare Advantage Plan”. These videos are biased because they have been beating this drum for so long, that even though the market, plan design, penetration rates, and provider temperature or network adequacy has changed drastically, their entire marketing funnel has benefitted so much from this fear mongering position that they would struggle to backtrack now. Also, most of their current Medicare Supplement clients consume their content, so if they put something out that says Medicare Advantage has gotten better, they’d likely have to handle a lot of service work from current clients that want to change their plans.
These agents likely had the best interest of their consumers at heart initially, but like a politician, sometimes they can get married to an ideology by name and have to pander to their “constituents”.. The solution here, is find an agency that offers all angles and do some research before talking to them so you can ask some pointed questions like, “How often will I be subjected to prior authorization on a Medicare Advantage Plan versus How often will my Medigap or Medicare Supplement Plan Increase”.. These are not questions that can be answered black and white, but a quality agent will have a satisfiable and honest answer to these. A weak agent will stammer and struggle to give you good insight.
Also, always ask them if they can offer all of the core carriers like UnitedHealthcare AARP, Blue Cross, Mutual of Omaha, Aetna, Humana, Cigna and Wellcare. A solid and well foundationed broker will have access to all of these. If there is a carrier that he or she doesn’t offer on that list, ask him or her why that is.
Medicare Advantage Only Agents in Call Centers
Perhaps one of the most dangerous are agents that are lunged into sales roles within call centers like SelectQuote, GoHealth, or EHealth. This is not a hit piece on those organizations, but since they’re all publicly traded, the shareholders want to see growth. That growth right now seems to be driven by Medicare Advantage Application count and they need more agents all the time to get on the phones. They also need more people to talk to, which has resorted to them using foreign call centers to drum up inbound calls from our most susceptible beneficiaries. I have been on these calls pretending to be a Medicare Eligible and flat out asked them to help me with a Medicare Supplement plan, and they refused. They just kept trying to shove the Medicare Advantage Plan down my throat. This type of behavior has led to increased regulation on all agents and brokers that has disproportionately negatively affected the smaller and older agents and agency owners. Any agent you talk to should offer help with both Medicare Advantage and Medicare Supplements (Also known as Medigap Plans).
Captive Agents Working for One Insurance Agency
This has long been something we have fought against. Both in the Medicare Advantage and Medicare Supplement world there have been companies like Bankers Life and Casualty (which sells Colonial Penn at often an unnecessarily high price), Physicians Mutual, and even some Medicare companies like Humana and UnitedHealthcare. Although, most of the Medicare Advantage companies like UnitedHealthcare, Wellcare and Humana that had captive agents have started allowing them to sell other products turning them into what we call a “Captive Broker”.
Our advice? Use a truly independent and experienced Medicare Agent that offers as many products and carriers as possible.
Smaller and Newer Independent Agents and Brokers
Smaller and newer agents are just simply less experienced. I know.. I have to train them in our office. The difference with our newest agents is they’re right next to a super experienced agent or many agents who have helped hundreds or even thousands of people.
This is a simple one. Ask how long they have done this and how many people they have helped. If they say something not satisfactory, ask if there is someone in the office more experienced that can help or consult them in the process. We want new agents to learn, but not at your expense.
Thank you for taking the time to read today. If you found this article helpful, please leave us a review, let us help you by calling us at 662-844-3300 and/or share the article with a friend or family member.
Take Control of Your Healthcare Choices
Navigating the intricate world of Medicare can be overwhelming, especially when you’re bombarded with conflicting advice from various sources. From healthcare professionals with specific biases to YouTube agents and call center representatives with their own agendas, finding trustworthy guidance is crucial.
Don’t let misinformation dictate your healthcare choices. If you’re tired of the back-and-forth, we’re here to help. Contact us today for reliable, unbiased assistance in making informed decisions about your Medicare coverage. Your peace of mind and financial well-being are our top priorities.