The intention of insurance is to cover costs. If beneficiaries are still spending $5,000 on out-of-pocket expenses every year with coverage, they are not being served well enough by the agent!
What is Causing This? (Data from Kaiser Family Foundation’s Most Recent Findings)
Premiums make up 42% of what beneficiaries pay out of pocket with coverage. ($2,294).
Medical and Long-Term Care Services account for 58% of the beneficiary’s Medicare out of pocket expenses. This includes long-term care facilities ($1,014), dental services ($449), medical providers ($712), and prescription drugs ($651).
*Medicare Out of Pocket Spending is Also Affected by Client’s
Age – 85 and older spent more than double OOP, than 65-74 years old.
Gender – Females spent more out of pocket than males.
Health – Poorer health attributes to higher Medicare Out of Pocket expenses. With chronic conditions, Medicare Out of Pocket spending doubled!
Supplemental Coverage – Those without Supplemental Coverage, incurred higher Medicare out of pocket costs. 1 in 6 Medicare beneficiaries (6.1 million) without, ended up paying $2,000 more than those with Supplemental Coverage.
Earn Trust and Mitigate Risk for Client’s Medicare Out of Pocket Expenses
Premiums and Deductibles
Clients with traditional Parts A and B, are set in stone, but you can help a client secure a low premium and deductible by enrolling them in a Part D plan. Since prescription drugs are sold by private insurers, contrasting different prices with different carriers will take research. Consider Medicare Advantage, (Part C), which may offer $0 premiums and cost-sharing.
In-Network vs. Out-of-Network
When visiting doctors, hospitals, pharmacies, plan members are to visit in-network providers. To save money on prescription drugs, even find the preferred pharmacy for their Part D plan! When seeing providers out-of-network (for routine care) the member would have to pay either 100% or a higher copay than in-network providers.
Supplemental Coverage
To pay a little more now, to save you in the future, consider Supplemental Coverage. Encourage clients to alleviate future cost; by accounting for long-term care, dental, vision, and hearing plans. People with Supplemental Coverage were covered by employer -sponsored, had higher incomes and more education.
*Imagine being a fixed income senior citizen, with a health insurance plan you think will cover all your costs in the future. You don’t want to pay even 1% of your income then! Be prepared.
