How To Avoid Having Your Medicare Insurance Changed Without Your Permission: 5 Things You Should Never Do
As we age, certain relationships grow in priority. Two in particular are your financial advisor and your insurance agent. Your insurance agent’s number one job is to protect you, your health benefits and government benefits, and to fight for you when needed. This is why it’s paramount you protect that valuable (and often, personal) relationship.
The Two Kinds of Agents: Captured and Fiduciary
There are two kinds of agents: captured and independent brokers who are fiduciary agents. What’s the difference? A captured agent works for the insurance company and can only offer you whatever the insurance company offers. An independent broker (fiduciary agent) may contract with 5 or 10 different insurance carriers, but he or she works for none. You see a fiduciary can only legally represent you, the client, and must do only what’s in your best interest. The beauty about this arrangement is your agent can look at many different plans to truly find the best one for you. It’s like being Progressive for Medicare!
The Threats You Must Avoid
Unfortunately, there are many who would love nothing more than to disrupt your relationship with your agent, who knows your wants and needs, and is constantly looking for ways to better your benefits. They do this in many different ways. Let’s look at five (5) of them.
1. Your Insurance Carrier
Now, this may sound ludicrous and crazy, but unfortunately even many insurance carriers would love to remove you from your agent of record (your agent). Why? Well, they won’t have to pay a commission. But there’s one more very valuable aspect they would like to remove, your agent being able to look at the competition and change your plan should a better one exist.
What many carriers (insurance companies) are doing is sending you letters, asking you to contact them for whatever obscure reason. When you call, they will tell you they can do (whatever) that is better for you, and ask you if you would like to speak with an agent. Then they connect you with an in-house, captured agent and switch your plan away from your agent.
What You Should Do
If you receive a letter from your insurance company, DO NOT CALL THEM. Call your insurance agent, who has the ability to call the insurance company on your behalf. Your agent can take care of whatever needs to be done for you and protect your relationship.
2. Medicare (CMS)
Again, one would think that the last two entities they would have to worry about would be their insurance company and Medicare itself. However, in many instances, if you call Medicare with any questions, their solution is to change your plan or, if someone changed your plan and you called them to put it back as it was, they do so and REMOVE YOUR AGENT. When you lose your agent, you lose your best advocate.
What You Should Do
If you have any questions whatsoever, do not call your insurance company or Medicare; call your agent. Again, your agent has the ability to fix any problem you may have, and knows who to contact, so you don’t have to.
3. Joe Namath, JJ Walker and William Shatner
Major companies run commercials with these popular celebrities, because they know we love them and they are influential. What the public is NOT aware of is that these are telemarketing operations who have contracts with insurance carriers. They run these obscure and vague commercials, touting:
- Get your Part-B premium back
- Get a Part-B giveback to reduce your premium
- Flex Cards
- Food Cards
- Utility Cards
When you call, they tell you that to see if you qualify, they need your Medicare number, date of birth and full name to check. You just gave them everything they need to change your plan without your permission.
What You Should Do
Always remember, if what they are trying to sell you is legitimate, your fiduciary agent can get if for you. Therefore, if you see something that gets your interest on TV, call your agent and talk with him or her about it. Believe me, we love getting food cards, givebacks and flex cards for our clients! Why? We want you to be happy and have ALL THE BENEFITS you qualify for. So, if you qualify, we WILL get it for you.
4. Junk Mail
I am sure your mailbox is full of lots of junk mail promising all the goodies for Medicare beneficiaries like you. The reason you get all that mail is because they cannot legally call you unless you give them permission. Two ways you do that is by calling them or sending in A POSTAGE PAID REPLY CARD.
What Should You Do
If you receive something in the mail that catches your attention, take a picture of it with your smartphone and text it to your agent. Again, if it is legitimate, he or she can get it for you.
The bane of our existence, the telemarketer. I don’t need to go into the annoyance this is and I am sure you are avoiding them like the plague. However, every now and then one sneaks through your well-planned defenses — and you answer the phone!
What You Should Do
If you accidentally answer the phone and you hear the words Medicare or healthcare benefits or health insurance or anything like that, you should say the following:
“I already have an agent. Please remove me from your list and do not call me again.”
Then, block their number on your phone. DO NOT ENGAGE with them. They are very savvy and will try to get the information they need to be able to change your plan. And you won’t even know it happened until you receive a new ID card in the mail. If that happens, here are the potential problems you may go through.
Potential Problems You Will Encounter
1. You won’t be able to go to your doctor. When they check your insurance, they will tell you they are no longer your primary care provider or specialist, because they may not be in the network.
2. You will need new referrals for any specialists. Referrals take time and could impact your care, if you can’t get the medical procedures or medication you need in a timely manner. When your plan is changed, assuming your specialists are in the network, you won’t be able to see them until your new primary care provider (PCP) requests the referral(s).
If your NEW PCP sees you in a week or two, on the first month your plan is effective, it can take two to three weeks for a referral to be approved. This means, best case scenario, you will wait approximately five (5) to six (6) weeks. Worst case scenario, two (2) months or more.
3. Possible delay of getting your prescriptions. If you are low on your medications, you will need to make an appointment with your new PCP so he or she can get you a one-time 30-day supply as a courtesy, until he or she can examen you and start your prescriptions again. Until you are seen by your PCP, your medications won’t be prescribed.
It’s a HUGE hassle and can have health-related consequences, not to mention monetary ones should you need to pay out-of-pocket for a service or medication, until everything is fixed.
Avoid These Potential Problems By Protecting Your Relationship with Your Agent
Hopefully, this will never happen to you. But if it ever does, you will appreciate and understand the value your agent offers you. Therefore, protect your relationship and call your agent TODAY and schedule your Annual Enrollment Period (AEP) appointment. This is where you go over changes to your plan for 2023, and what other plans may be available in your area. And, as always, making sure your doctors accept it and your medications are covered. Believe me, you will be happy you did!
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