2021 Guide to the Best MEDICARE Plan

Digest the facts and dismiss the fears today.

From the desk of:
Aubrey Allred
Founder and President – Aubrey Allred Jr. Insurance 

Hi there!

In the midst of this global health crisis that’s turned our world and lives upside down in seemingly the ‘blink of an eye,’ I’ve got an important message for you.

In fact, if you’re within 90 days of turning 65 to 68 and plan on retiring, or you’re within 90 days of turning 70, this special report is an absolute MUST READ. 

Please, close the door, sit down, and pour over this time-sensitive message.

Frankly, I’ve been busier than a beehive in springtime. 

I’ve been swamped, helping seniors get the best Medicare coverage to ensure that they have the best plan that limits their out-of-pocket costs as their medical bills rise and income declines in retirement.

That’s why I’ve gone through all the effort to write and deliver this information. 

I want to ensure that YOU have the best Medicare health plan for retirement that works for your personal, unique health and financial situation.

Sadly, far too many are side-swiped with unexpected, unplanned, and unmanageable health care costs they are liable for. These victims are left with worry, stress and heavy loads of debt that turn their golden years into a living nightmare.

That’s why making the right choice for your medical benefits is more crucial in retirement – a time when most seniors transition to a fixed income, which is usually lower than when they were working, while their health care costs rise due to age.

In short, health costs rise and income declines. 

My Promise to You

You don’t have to struggle to pay your medical bills caused by a lack of coverage in retirement! 

I clarify and reveal the LITTLE KNOWN TRUTH about Medicare plans and provide a clear track towards securing the very best Medicare plan for your needs.

With a clear understanding of the options available, you too can enjoy the very best coverage with the least out-of-pocket costs for a longer, healthier and happier retirement!

Before we dive into the most common myths that millions, and perhaps even you, have concerning Medicare plans, let’s set a firm foundation.

What is Medicare?

Medicare is the federal health insurance program for:

• People who are 65 or older
• Certain younger people with disabilities
• People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

The different parts of Medicare help cover specific services:

Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance)  

Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Medicare Part D (prescription drug coverage) 

Part D adds prescription drug coverage to:

• Original Medicare
• Some Medicare Cost Plans
• Some Medicare Private-Fee-for-Service Plans
• Medicare Medical Savings Account Plans

These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.1

Eligibility

You become eligible for Medicare 90 days before turning 65 as long as you plan to retire from your job at that time – and are thus dropped from your company’s health insurance plan.

Enrollment Options

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. 

There are 2 main ways to get your Medicare coverage:

1. Original Medicare (Part A and Part B) 
2. Medicare Advantage Plan (Part C) 

ADDITIONAL OPTION: Some people need to get additional coverage, like Medicare prescription drug coverage and/or Medicare Supplement Insurance (Medigap). 

Now, let’s take a closer look at what most seniors think about Medicare and what the real story is on your health insurance options.

5 Medicare Plan Myths Most Seniors Believe

You’ve heard the saying, “The devil’s in the details,” right?

Well, that’s why we’re going to dive deeper into the truth behind the myths concerning Medicare.

If you only read the Medicare website, you may walk away either totally confused or naively confident that you know what’s going on and know which option you should choose.

Let me insist…you don’t!

As an insurance agent with 40 years of experience, I know how many scenarios play out when choosing various options, which is why I’ve gone through the painstaking work of crafting this report.

There are many myths that people believe concerning Medicare that end up costing them a fortune, others are even forced into bankruptcy, and still others…worse!

MYTH 1: Medicare Part A & B is Good Enough Coverage

This is probably the most fundamental belief, which is why it’s a good place for us to start our journey toward the best Medicare coverage.

Medicare claims that part A and part B combined will pay about 80% of all of the hospital bills, the doctor’s office bills, and other related medical costs. That means you would be left with 20% of your medical costs to pay for out of YOUR pocket.

If that were the ACTUAL truth of the matter, it would look something like this.

Example: Let’s say that Janice, who’s 68, had to have hip surgery and the total cost was $20,000. If 80% of this cost was covered by Medicare Part A & B, then she’d be left with a bill of $4,000. Janice is in retirement on a fixed income so this bill already surpasses her financial means. And the truth is, it’s too much money for most seniors.

However, the TRUTH is that the claim of Medicare paying 80% is not reality.

Remember this, when the government says that part A and part B pay 80% of your bills, their estimate of ‘80%’ is based on what they think the doctor and/or the hospital should charge, NOT what these medical service providers actually charge.

So then, if the hospital, doctors, and other medical service providers charge higher fees, which they infamously do, YOU are liable for paying the difference!

Example: So, let’s say that Janice’s hip surgery cost $30,000, instead of 20. Let’s say that Medicare Part A & B allots for paying the 80% based on $20,000 – or $16,000 total. This means that instead of owing just $4,000, Janice is now on the hook for $14,000 in medical bills…out-of-HER-pocket!

Since most medical services are ACTUALLY higher than their estimates – particularly for higher quality providers – Medicare A & B typically only pays about 45 to 50% of an individual’s overall bills. 

PRO TIP: Janice’s smartest move would have been to add a Medicare Supplement Plan G to her Medicare plan, to strictly limit her risk and ensure premium and complete health care coverage.

She would pay a little higher monthly premium for Medigap (also called Medicare Supplement) insurance but her deductible would be minimal $198 for the year of 2020 – but after she meets her deductible for the year, she gets complete coverage for all her medical costs for the year.

Example: So, let’s say that Janice’s hip surgery cost $30,000, instead of 20. Let’s say that Medicare allots for paying the 80% based on $20,000 – or $16,000 total. This means that Janice now has a remaining $14,000 in bills, not to mention any other medical expenses she accumulates in the year of coverage.

Janice is not worried; she smiles with a peaceful assurance knowing her Supplement Insurance has her covered. She simply pays her $198 deductible (again, this varies each year along with monthly premiums), and the rest of the $14,000 bill plus any other bills that she has for the year are fully covered by her Supplement Insurance. 

Analysis: In an attempt to save money by just going with the Medicare Part A & Part B, your frontend costs are low but, on the backend, if your medical costs are high for any given year, which is highly probable, then your out-of-pocket costs could be negligible and put your finances and health in jeopardy. 

With Medigap Insurance, your monthly costs are a little higher on the frontend, but it’s worth it because your backend costs are minimal. In most cases you have ZERO copays and your annual deductible is low. You enjoy a typically small deductible and full coverage for the year, thereafter. 

Take the Best Next Step! 

MYTH 2: Medicare Advantage is the Most Affordable Option Since it’s ‘Free’

This is probably the most common myth of them all, so let’s discover the true story.

What is Medicare Advantage? 

Sometimes called “Part C” – includes both Part A (Hospital Insurance) and Part B (Medical Insurance). Private insurance companies approved by Medicare provide the coverage plans. You may choose your providers by health care providers who participate in the plan’s network. 

Costs:

• In 2020, the standard Part B premium amount is $144.60 (or higher depending on your income).
• You usually pay a monthly premium for your MA Plan (in addition to your monthly Part B premium).
• You may pay a copayment or coinsurance for covered services. Many MA plans offer vision, hearing, and dental coverage. Costs, extra coverage, and rules vary by plan.2
• Though plans have a yearly limit on your out-of-pocket costs, they are usually much higher than the out-of-pocket costs for Supplement Plans. Once you reach that generally high limit, you’ll pay nothing for covered services for the rest of the year.

Certainly, you’ve seen the commercials offering Medicare Advantage Plans with Dental, Vision, Hearing, and Drug Coverage all with $0 premiums, deductibles or copays.

Another popular commercial promises FREE hearing aids, eyeglasses, meal delivery and rides to appointments.

Have you ever heard the saying, “There’s no such things as a free lunch?”

It’s true in the case of Medicare insurance. In fact, ‘free’ often ends up costing seniors a fortune. What’s worse, many of these seniors don’t have a fortune to give.

For starters, the small print in all of these commercials and ads allude to the many restrictions, limitations and annual maximums, as well as the availability based on carriers and locations. 

Still, because of the big promises made in these ads, tons of seniors call in looking for a ‘free lunch.’

Secondly, even if you do qualify for these ‘free’ plans, most people may not prefer them because they come with higher risk of high out-of-pocket medical costs. 

Medicare Advantage Plans Pros & Cons

Before listing pros and cons, know this; there are multiple plans and a lot of variables, making it difficult to make a clear-cut pros and cons list. Generally speaking, these are the features in Advantage Plans.

Pros of Advantage Plans:

• Low to No Monthly Premium – Some advantage plans do offer $0 monthly premiums. However, these same plans typically come with very high deductibles, co-pays, and other backend costs
• Potential Free Perks – It is possible for some to get Dental, Vision, Hearing, and Drug Coverage. And also, qualifying members get things like FREE hearing aids, eyeglasses, meal delivery and rides to appointments

Cons of Advantage Plans:

• Higher Risk of Out-of-Pocket Medical Costs – The high cost of ‘free’ advantage plans are deductibles that can be thousands, higher co-pays, and other costs. That’s why many Advantage Plans feel more like ticking time-bombs just waiting to explode your budget with high medical bills you can’t afford 
• Strict and Limited Network of Medical Providers – Advantage plans offer a limited and smaller list of ‘in-network’ doctors, hospitals and other medical service providers. This could mean that your doctor, more desirable professionals and hospitals, and specialists could be ‘out-of-network’ for the care that you need. So, while you may get a lot of miscellaneous perks, you may not get the core and essential health care that you want and need.
• Significant Variables – There’s no standardized benefits you can know you will receive from year to year, person to person, or state to state. 

Also, please note that once you’re locked into a plan for the year, you’re stuck with it. You can’t back out and change plans until the new open enrollment period for the next year begins. 

Bottom line, there’s no such thing as a ‘free’ lunch. 

Your high out-of-pocket costs for medical services and the significantly smaller network of healthcare providers are common problems seniors have with Medicare Advantage Plans.

Take the Best Next Step! 

MYTH 3: Medicare Supplement Insurance (Medigap) Offers Less Than Medicare Advantage

Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay the remaining health care costs, like:

• Copayments
• Coinsurance
• Deductibles

Some Medigap policies also cover services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here’s what happens:

1. Medicare will pay its share of the Medicare-approved amount for covered health care costs.
2. Then, your Medigap policy pays its share.3

Note, you must have Medicare Part A and Part B to be able to then ‘supplement’ that plan.

A Medigap policy is different from a Medicare Advantage Plan.  MA plans are ways to get Medicare benefits, while a Medigap policy ‘supplements’ your Original Medicare benefits.

NOTE: You’ll need to purchase a separate Pharmacy Plan with Supplement Plan G, as this plan does not cover prescription drugs. You should definitely purchase the pharmacy plan because if you don’t buy a pharmacy plan when you are first eligible, then you will pay an increased premium penalty for the rest of your life.

Now, let’s compare some big differences between Advantage and Supplement Insurance.

The Story You Haven’t Heard About Medicare ADVANTAGE and Medicare SUPPLEMENT PLAN G

There have been several studies done by the Henry J Kaiser family foundation. 

The studies found that half of all Medicare Advantage enrollees would incur higher cost than a boomer that just has part A and part B Medicare with no supplement. 

After five days in the hospital, the individual that had a Medicare Advantage Plan would still be out of pocket 50% more than an individual that did not even have a supplement. In other words, people who ONLY had Medicare A and B would pay 50% less than those that had Medicare Advantage.

That same study at the Kaiser family foundation also found that for the average Medicare Advantage enrollee, their average out-of-pocket would be $4,980.00 for ‘in-network’ services – meaning hospitals in their network. 

Or, the enrollee would pay $8,828.00 of their out-of-pocket costs if they were to go ‘out-of-network’ when compared to an individual that had a Medicare Supplement Plan G. 

A Supplement Plan G for 2020 only has a $198.00 deductible. During the year 2020, everything else is paid 100% by Plan G and Medicare Part A and Part B. 

The actual maximum out-of-pocket cost to a Medicare Advantage enrollee is $6,700 for the year of 2020 for ‘in-network’ medical costs.

After that Medicare Advantage would pay 100% of everything else. 

If that same individual had a Supplement Plan G, they would, again, only pay their $198 deductible plus their supplement premiums for the year 2020 before Plan G, Part A & Part B paid 100% of all remaining medical costs. 

FACT: Monthly insurance premiums change from year to year, so we can only calculate what you’ll pay in the year of 2020 and you should plan on it changing in the year 2021. 

Quick Chart:

In a Nutshell

As you can see, Medicare Advantage Plans have the edge on… 

• extra perks
• pharmacy plans included 
• lower monthly premium

Medicare Supplement Plan G takes the prize of the best health insurance option for what matters most…

• low annual deductible
• out-of-pocket costs for any medical costs you have throughout the year
• freedom to choose your desired medical services providers from a broad network of options

That’s freedom, flexibility, and peace of mind.

PRO INSIGHT: Most Medicare Advantage plans also require that if you need durable medical equipment, spend days in a nursing home facility after a hospital stay or go to the hospital for a non-emergency event, you must have pre-approval and permission/authorization or there is no coverage. 

None of these headaches exist with Medigap insurance. 

With Medigap Insurance, if you feel like you have to go to the hospital you go. If your doctor believes that you need to have a surgery or that you need to see a specialist then you go to whoever you want to go and see without any pre-approval or penalties.

Take the Best Next Step! 

Schedule a No Cost, No Obligation MEDICARE SOLUTIONS CONSULT with the Health Insurance Expert, Aubrey Allred. In this video meeting or phone call, you’ll get all your questions answered and find the very best Medicare insurance solution for your individual needs. 

MYTH 4: Insurance Agents Recommend Programs That Are Best for Their Commissions, NOT Their Clients

Sadly, this is exactly how some insurance agents and agencies operate. 

On the other hand, I am an independent broker, which means I don’t recommend just one brand of options like some agents, I have several companies that I am able to offer to you and the Medicare Supplements have the same benefits regardless of the insurance company (i.e. a Plan G has the same benefits offered to the insured regardless of the insurance company). 

In fact, you’ll get to see and compare the plans offered by top carriers, including Blue Cross Blue Shield and other providers, to select the plan that suits your unique needs. With the carriers I recommend, you get all the same benefits, coverage and service. 

It’s my job to ensure your premiums are as low as possible and that’s what I do for all clients. 

Secondly, in my 40 years of serving Texas insurance customers, I’ve always believed in the Golden Rule – ‘Do unto others as you would have them do unto you.’ 

That’s why I offer honest advice to customers and recommend ONLY the insurance programs that work best for THEM…never myself.

If after consulting with a person we find that the best insurance solutions for them are something I don’t offer, I recommend them to other experts who can help them without blinking an eye. That’s what professionals do.

This has paid off for me with long-term, happy customers who recommend more customers to me.

MYTH 5: My Insurance Agent Will Promise Great Service But Will Vanish Once They’ve Signed Me Up

Being in the insurance business for 40 years, I’ve heard of countless horror stories of insurance agents providing little to no customer service for their clients after they’ve signed up. 

My team and I feel like this way of operation is deplorable. 

Frankly, I just picked up a new couple the other day because they’ve not been able to get in touch with their agent in two years!

The good news is that’s not how Aubrey Allred Jr. Insurance operates.

We build close client relationships. Always have and always will. 

Several Points of Client Contact:

1. We contact all of our clients at least annually by phone for a one-on-one check in chat.
2. We send out a newsletter to you every monthly they would be hearing from us 12 times per year.
3. Finally, we’re always available. So, you can call anytime with questions or concerns.

Take the Best Next Step

Undoubtedly, you still have a lot of questions about what you’ve just read and about your Medicare health insurance options. Plus, you may have questions about other insurance needs, such as life insurance and dental-vision insurance.

That’s perfect!

The best next step for you is to schedule your no-cost, no-obligation Medicare Consult with me personally, to get answers to all your questions.

In this video meeting, you’ll meet face-to-face with me from the convenience of your own home, to get all your questions answered and find the very best Medicare insurance solution for your individual needs. 

Whether you have questions about Medicare Advantage vs. Supplement Plan G, life insurance, dental-vision insurance, or something else, I’ll put my 40 years of expertise to work for you!

I’ll show you the real options, numbers, benefits and we’ll be able to compare everything and you’ll walk away with clarity and confidence on the best Medicare Plan for your unique needs.

Again remember, there’s NO COST and NO OBLIGATION, so…

In addition to getting clarity on Medicare benefits, I’ll also give you a wonderful free gift. 

It’s an e-book called “My Life Story As Lived And Written By You” co-authored by David Douglas Ford. 

It’s a 106-page book with a lot of different questions about your life. You have the ability to fill in the answers to the questions and leave it behind for your loved ones after you’re gone or maybe you read it with them while you’re still living.

This book is geared towards seniors, age 60 and older. It helps you share your story and legacy with your family and descendants – an important heritage builder for multi-generational family culture. 

David was a personal friend of mine and he passed away since writing the book.

It’s simply a wonderful book I know you’ll love. I’ve been giving this book away to my current clients and they absolutely love it.

PRO TIP: Do NOT choose your Medicare benefits alone. Let a professional chat with you, answer all your questions, clear up any fuzzy facts and show you the real numbers, options and plans available to you in real time.

Once again, you’ll have to live an entire year with the decision you make and if you make the wrong choice, it could cost you a lot of money, time, and perhaps even your health. 

 Schedule your no cost, no obligation Medicare Solutions Consult today!

Sincerely,

Aubrey Allred Jr.

References:

1. Medicare.gov, U.S. Centers for Medicare & Medicaid Services, May, 2020, https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare

2. Medicare.gov, U.S. Centers for Medicare & Medicaid Services, May, 2020, https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices

3. Medicare.gov, U.S. Centers for Medicare & Medicaid Services, May, 2020, https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap