By SYLVIA GORDON
Guest Columnist
This depends on your ZIP code, health, the medications you take, how much you travel out of state, which doctors you see and what hospital you would prefer to use. Often the “best” plan is financially out of reach, so your budget will determine what is the best option for you.
I know, I know. No one likes to sit down to a protracted discussion about Medicare insurance options. After doing this for over two decades, it no longer hurts my feelings that working with me in not a high point for my clients. But unless you are very wealthy, and money is no object, I insist that you muddle through learning the options that are available to you and hear me out.
“My sister has Anthem, she loves it so that’s what I want to purchase,” is a common statement I hear. I’ll use Anthem as a starting point. Anthem is a very good company and is headquartered here in Indiana. We are one of the top five distributors for Anthem nationally, so I am both very familiar and very fond of Anthem’s Medicare products. It will be hard for you to digest when I don’t recommend Anthem to you.
Based on the doctors you see, and the insurance they accept, you might be better served with Humana, Aetna, or AARP. “But my sister says Anthem is the best plan,” you say. And Anthem may be the best plan for her. You and your sister don’t see that same cardiologist. You don’t take the same medications, and she lives in Nebraska, while you live in Indiana. In other words, there is no “best Medicare plan” – there is only the plan that you and I both feel will best meet your individual needs for next year. And it may change the following year.
I love to use my parents as an example. People assume that married couples will purchase the same type of Medicare insurance plan from the same company. That’s not always the case. My mother purchased a Medicare Supplement Plan G. It costs more upfront each month but has no co-pays for services. While my father purchased a Medicare Advantage PPO with a $0 monthly cost, he pays co-pays when he uses his plan. They both have been on their plan for years, are very happy and feel that they have the “best” plan. It’s even more interesting since they are also both licensed insurance agents who understand Medicare better than 99 percent of the population.
Medicare insurance plans are priced based on your ZIP code. It’s counterintuitive though. If you live in a big city, you usually pay less than rural areas. Thinking about retiring to Florida? You will pay a lot more for the same plan that you have in Indiana. A Medicare Supplement will cost nearly double in New York!
This concept irks my clients, but it makes sense in a for-profit system. The insurance companies price their plans to make money, and that is based on the cost of medical care in your state. Many won’t file a plan at all in Washington state due to their onerous insurance laws. You have dozens of options in Indiana, but if you want a Medicare Supplement in New York, you have only a handful of companies to choose from.
Medicare Supplements cannot change their benefits. As long as you continue to pay your monthly premium, you are guaranteed those benefits, unlike Medicare Advantage plans which change every year. Change isn’t necessarily bad, as Indiana has experienced quite a few years in a row of benefits getting better each year (but I expect that to change in 2023). My point being: What is “best” in 2022 might not be as attractive in 2023.
Licensed insurance agents are strictly forbidden by federal rules from uttering the word “best, better” or any superlative when talking about Medicare Advantage and Part D drug plans. If a lot of this makes no sense to you, join the crowd. Medicare is a very well-run government program. I’m proud to work with Medicare beneficiaries, but I would like the freedom to tell you in plain English what I feel is the “best” plan for you. But I cannot.
Sylvia Gordon is the president of Gordon Marketing, headquartered in Noblesville, where she trains on Medicare and Social Security in all 50 states. You can contact her at sgordon@gordonmarketing.com.