Edna is not the real name of the person I am writing about but you can be sure this is a true story about a client of mine I met with last week.
Edna was in a Medicare Advantage HMO with a major carrier here in the WNY area, The reason she contacted me was the fact that she was becoming overwhelmed with a pile of medical bills that were beginning to to cause her and her husband.
You see, a couple months ago Edna was diagnosed with lung cancer. It is at that point that I advise ALL of my clients that are on Medicare Advantage plans to immediately contact me so we can get them into a Medicare Supplement plan. Edna, however, was not a client of mine yet.
Here is what happened. Edna was told by her primary that she needed several preliminary tests before a treatment plan could be established. What she was not told that with an HMO every place you go MUST be in network.
At the time, she was visiting her daughter in another state so she called around and found a place to get the tests done. The problem was they were all out-of-network! When Edna came home she had thousands of dollars in bills waiting for her.
In a Medicare Supplement plan, especially the “F” Plan, this would never happen. In fact, she would have ZERO bills.
As many of you that are clients of mine know, I do not recommend a supplement to people that are relatively healthy. If possible, I make sure all my clients are on NY State Epic so the have the option to freely move from one plan to another. In this case, if you get a diagnosis that you will be requiring multiple hospital stays or treatments you can move into a Supplement when you need to.
In Edna’s case, we did move her into an “F” Plan. So going forward, she will not get any more bills.
If you have any questions about Medicare or Medicare Plans feel free to give me a call or send me an email.