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  • Writer's pictureKen Connolly

The Medicare Advantage Secret Weapon

Updated: May 22



Summary:

  • Many Medicare Advantage enrollees face high medical bills when facing severe illnesses like cancer and heart disease

  • This is because many Medicare Advantage plans have annual out-of-pocket maxes of $6,000-$10,000

  • Critical Illness insurance is a cost effective way to help combat these large bills

  • You must enroll in critical illness insurance BEFORE a major illness happens


Medicare Advantage Secret Weapon:


During Medicare Annual Enrollment, we had many new prospective clients come into our office and mention that they had around $10,000 in medical bills from cancer treatments. Unfortunately, there was nothing anyone could do to fix it. 


Do I have your attention now?  


In this article we are going to talk about what type of plan these people had that caused them to accrue so many bills, why they couldn’t change their situation, and most importantly, the secret weapon we use to stop this from happening. We have helped thousands of people with their Medicare, and we are now looking forward to helping you with this article! 


What Type of Plan Caused This? 


These new clients that walked into our office with $10,000 in medical bills were enrolled in Medicare Advantage plans. Medicare Advantage plans are a private equivalent to Original Medicare. While there are some major perks, they do run on a pay as you go structure. This means that you usually have a low monthly premium, but you pay for different medical procedures and needs as they come up.  


Most of these policies in New Jersey have Out of Pocket Maxes that range from around $6,000 to $10,000 a year. They were hitting their out-of-pocket max due to their severe health issues. Things like cancer, a heart attack, or other ailments can quickly lead to large, unexpected bills. The Medicare Advantage Out-Of-Pocket Max varies greatly depending on your state and zip code. 


Many people have great experiences with Medicare Advantage plans, but any insurance plan has risks. And this is the biggest risk in our eyes.  


Why They Couldn’t Change It 


They couldn’t change these bills for 2 reasons. The first is, it’s already happened. You can’t get insurance AFTER the incident has occurred. You can’t start a new auto insurance policy and file a claim on an accident that’s already happened. You can’t start a new homeowners insurance policy and file a claim after a tree has fallen into your house. You must insure yourself before the issue. That is why they were stuck with these high bills. 

I can’t tell you how many people I have told this to who are shocked to find this out.


Don’t be blindsided.  


The second reason is that once you are diagnosed with a condition like cancer, it will be some time before you can move to Original Medicare with a Medicare supplement. Let's have a brief explanation of Medicare Supplements vs Medicare Advantage. Medicare Advantage is a private equivalent to Original Medicare that uses a pay as you go structure. Medicare supplements often have higher monthly premiums, but usually have MUCH lower out of pocket costs for hospital and medical coverage. You will pay more per month, but instead of around $10,000 in out-of-pocket expenses over the course of the year, it could be more like $1,500-$2,500.  


If you have cancer or had a serious heart issue recently, you won’t be able to switch to a Medicare Supplement. You’ll have to wait until you have been cancer free or serious medical issue free for at least 2 years in most cases. In some states, you may be able to switch into a supplement with no underwriting. But there may be a waiting period for any conditions you acquired prior to switching to a Medicare supplement. Either way, you could have some high medical bills. 


The Secret Weapon to stop this: 


There is a cost-effective way to combat the high costs of these medical bills you could accrue in a Medicare Advantage plan. And it is called “Critical Illness” Insurance.  

Critical Illness Insurance is a type of insurance to protect you against the high costs of diseases like cancer and heart disease. These policies are simple. You take out a policy for about $15-45 a month that will pay on average $5,000-$15,000 if you get a specific illness. In most cases, a cancer policy costs about $25 a month for an older adult and will give you $10,000 towards your cancer bills. 


If you remember from earlier, we mentioned many Medicare Advantage plans had out of pocket maxes of around $10,000 depending on the state you’re in. You could use this policy to pay for a year of cancer treatment.  


What Are the Conditions? 


In most cases, you need to have not had cancer or a heart attack for 5-10 years to qualify for these policies. The underwriting standards aren’t high, you just need to have not had these major medical issues. You also need to show you have comprehensive medical coverage. And a Medicare Advantage plan fits this bill perfectly.  


Again, you need to get this kind of policy BEFORE something bad happens to you.  

You also can sign up for these plans ALL YEAR LONG. You don’t have to wait for any enrollment period to sign up. And the sooner you do, the better.  


How does it work? 


Once you open one of these policies, the result is simple. If you get the illness you insured, you will get the full benefit amount of the policy. If you signed up for a cancer policy, and you get cancer, you will get your benefit amount. 

It works a lot more like a life insurance policy than a health insurance policy. You can even set up beneficiaries to get the benefit if you are not able to claim it due to your passing.  


How to get this policy 


We’d recommend calling a health insurance broker as soon as possible if you are interested in this kind of policy. If you’d like our help, reach out to us at 848-226-6897 to dive into your options. We are licensed in over 20 states and happy to help. You can also visit our website at www.njlifeandhealth.com 


If you have any topics you’d like us to cover, leave us a comment below! And share this blog post with anyone who you think could use this help 

 

 

 

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