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Why I help people with Medicare

Good Sunday morning!

The Dog Days of summer have officially arrived here in East Tennessee.

Many people around here are looking forward to the Great Solar Eclipse on August 21 of which we are in the direct path. Anything that brings down the temperature just a little bit for a few seconds is certainly welcome.

One question I often receive from the many people I have been privileged to help with their Medicare is why I have chosen to make this particular area of interest my life’s work.

I’d like to take just a few minutes this morning and answer this question because it involves a lesson that could be very important to you.

Prior to the passage of the Affordable Care Act in 2010, I had a nice business helping lawyers with their health insurance and other insurance needs. Specifically, I helped attorneys who were just starting a small law practice.

I was helping a lot of people and providing a decent life for my family. Then the Affordabale Care Act – or Obamacare passed – and one aspect of this legislation impacted me more than any other. I could keep helping the people I had been helping except I would no longer be able to support my family doing so because they authors of the bill chose to drastically reduce the compensation for people like me.

So like a lot of people in today’s world I had to change or starve. I had been helping a few of my clients with Medicare once they were eligible. I found I enjoyed sharing with them the much better access they had to health care once they were on Medicare and at usually much lower monthly cost.

And I thought if I worked very hard and helped enough people who were going on Medicare to understand their choices I could make a difference in their lives and provide a nice life for my family as well.

However, as I started to help more and more people with Medicare, I realized how many people had, when they first became eligible for Medicare, been steered into private, for-profit, managed-care HMO plans called Medicare Advantage.

As opposed to regular Medicare, with a Medicare Advantage plan someone actually leaves regular Medicare and signs over their Medicare benefits to a private, for-profit company. This company then makes all the decisions about their health care – including what if any tests and treatments to cover if someone becomes sick.

Because Medicare Advantage plans get a fixed amount of money from the government when they take over someone’s Medicare benefits, they actually make money by saying “no” to many of the tests and treatments people need when they become sick.

I suddenly began hearing horror stories from hundreds of people who had felt they were misled by Medicare Advantage salesmen. These people were paying far more for their health care than they should and often were not able to access the health care they needed when they needed it.

Even worse, they now found themselves unable to return to regular Medicare and be approved for a Medicare Supplement to cover their share of Medicare. The reason for this is someone can usually only enroll in a Medicare Supplement without passing a health screening when they first go on Medicare.

These people with Medicare Advantage plans had passed up their Medicare Supplement Open Enrollment window and now were ineligible for a Medicare Supplement due to various health issues.

I heard stories from people who believed their loved ones had died because the expensive treatment they had needed to save their life was denied by their Medicare Advantage plan because of the cost.

I received a call from a lady who was moving from Colorado to South Carolina. She was moving there to live with her daughter because her husband had just passed away and she was now alone in Colorado.

When I asked her about her Medicare situation, she told me she and her husband had both had a Medicare Advantage plan in Colorado. Her husband had developed stomach cancer.

However, they and their grown children had been distraught because the Medicare Advantage plan to which they had assigned their Medicare benefits was only willing to pay for less expensive cancer treatments.

Instead, they traveled to Cancer Treatment Centers of America where they received very good and very bad news.

The good news was the doctors at Cancer Treatments Centers of American felt certain that a relatively new but expensive cancer treatment would save his life.

The bad news is because they had signed over their Medicare benefits to their Medicare Advantage plan, they would have to pay the full cost of the treatment – nearly $100,000 out of their own poockets.

This man was left with the choice of using he and his wife’s life savings to try to save his life or choose to die knowing his wife would have the money she needed the rest of her life.

He chose to make sure his wife had the money she needed and he died.

Had this couple stayed with regular Medicare and enrolled in a Medicare Supplement that paid their share of Medicare, he could have received the treatment he needed at Cancer Treatment Centers of America and the entire cost would have been covered 100 percent.

This is why I have made it my life’s work to try to help as many people as possible understand their choices when they first go on Medicare so they can make the right decision for them.

I would appreciate the chance to help you understand your Medicare options so you can choose the right Medicare plan for you both now and in the future when the choice you make today could make all the difference.

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