Are You Using the Medicare Tools Available to You?

BY MAGGIE STEDT

Many agents, whether just starting out or experienced in the Medicare focused market, rely on the company trainings and certifications offered American Health Insurance Plans (AHIP), Gorman, NAHU or other companies. While certainly they are important components and a necessity, there is so much more that the Medicare focused agent needs to know to be able to assist their Medicare beneficiary clients.

The www.medicare.gov website provides most of the information and the materials that the informed agent needs to access. The site contains a wealth of information and resources. The three most important materials or textbooks as I call them are:

1. 2021 The Medicare and You

2. 2021 Choosing a Medigap Policy
3. Your Guide to Who Pays First

These three publications are key to your understanding of Medicare and other health benefits and should be read cover to cover and referred to as needed.

The www.medicare.gov website provides most of the information and the materials that the informed agent needs to access.

The Medicare and You Handbook

This handbook changes yearly and covers information from signing up
for Medicare, understanding Original Medicare, Medicare Advantage Plans, Medicare Supplement Plans and Prescription Drug Plans. It outlines what services, tests and items are covered and not covered under Part A and Part B of Original Medicare. It covers the enrollment periods and the optional coverage and types of plans. It also provides resources for other Medicare Information. There is information regarding Medicaid, extra help, the appeals process, protection from fraud plus definitions of terms and much more.

2021 Choosing a Medigap Policy

This booklet is required to be provided to the Medicare beneficiary at the time you are presenting a Medicare Supplement (Medigap) plan. It is the guide to what Medicare Supplement plans cover, a beneficiary’s rights to buy a Medigap policy and how to buy a Medigap policy. It is a helpful tool
in addition to the actual company‘s Medicare Supplement Enrollment kit. I find the sections on “What is Medicare,” “Your Medicare Options,” and the chart showing the plans and the benefits of the various Medigap options are especially helpful. Clients are able to take notes and highlight what is important to them during their appointment.

Your Guide to Who Pays First

This booklet helps you to understand how Medicare works with other types of coverage such as Small Group, Large Group, Retiree, Veteran’s benefits, TRICARE, Workers Compensation, No Fault and Liability Insurance, the Federal Black Lung Benefits Program, ESRD and COBRA. It is a resource for when the beneficiary has a question on the coordination of benefits. This guide is a must for you in working with clients with other coverages and will help those agents who work with employer groups.

While these booklets are great guides, bear in mind that changes may occur after their printing so it is important to visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) for the most up-to-date information.

Make time to review the www. medicare.gov website in depth as it offers far more than the plan and prescription drug finder. Through this site you have access to how to apply to Medicare, understanding Medicare costs, addressing Medicare card issues and a review of the mail that is sent to a beneficiary. There is also so much other information such as:

• Understanding the Order of the Medicare Part A and Part B Enrollment Periods

• Income Related Monthly Adjustment Amount (IRMAA)

• Part D Penalty Amount for Current and Past Years

• Claims & Appeals

• Manage Your Health

• Forms, Help, & Resources

• Where can I get covered medical items?

• Get Medicare Forms

• Publications

• Information in other languages

Through the Publications section there are other booklets that you can order and provide to your clients. Some of these include: “A Quick Look at Medicare,” “Enrolling in Medicare Part A & B,” “Medicare and Home Health Care,” “Medicare Coverage of Durable Medical Equipment and Other Devices” and many many more. Topics include addressing skilled nursing, hospital care, enrolling in Part B when outside the country and so on. There are also ebooks you can download as well.

If you are on Medicare yourself, you should create a www.mymedicare.gov account as it not only provides information for you personally but can help you to learn just what information is also available to your clients. They may wish to share their information with you in order for you to assist them since you are a “trusted advisor.” Remember, always be mindful of HIPAA compliance when assisting your clients on this site.

Also, sign up for the email updates from Medicare in the Publications section of the site to keep you up to date on Medicare information and programs! The site also provides Helpful Links and links to CMS and HHS websites. There is so much to learn and to be aware of that we could fill up this entire magazine! I recommend that you take some time to go to www.medicare.gov and begin your in-depth learning process. As a Medicare knowledgeable agent you will be far better prepared to assist your clients and grow your business!

MAGGIE STEDT is an independent agent that has specialized in the Medicare market for the past 21 years. She is currently president of California Association Health Underwriters (CAHU) and is a past president of her local Orange County Health Underwriters Association (OCAHU) chapter.

Reach her at maggiestedt@gmail.com.