In In the Greek myth of the Minotaur, a creature with the head of a bull and body of a man dwelt in the middle of a labyrinth. Built by Daedalus and his son, Icarus, the labyrinth swallowed all who dared to enter. Until the hero Theseus. Following his beloved Ariadne’s advice, the hero followed the labyrinth down and down into its center, never wavering to the right or to the left. Trailing a string behind him, Theseus came finally upon the beast, and after a mighty fight, slayed it there in the center of the maze.
Great story, right? Something straight out of a Ridley Scott movie. Though Theseus may be a hero clear out of the pages of myth and legend, a modern tour guide into the labyrinth exists, and will lead you through the mystery that is Medicare.
Ruth Page has lived in Orange County for just over two decades. Having spent a great many years in financial services, Ruth established Porter Page and Company, Inc. in the year 2000, and has been in the business of helping clients navigate the maze of healthcare options, specializing in Medicare insurance ever since.
“I first moved to Aliso Viejo in 1996. I love Orange County, and I can’t imagine living or working anywhere else,” says Ruth. “Well … maybe on a small farm with goats and chickens in Vermont or upstate New York.”
Realizing that her clients felt like they were battling their own beasts with Medicare was the first step to unspooling the Thesean thread: leading those lost in the labyrinth to sunshine. Sifting through the sludge of printed propaganda, government issues, and filtering healthcare noise is enough to drive anyone toward the feeling of quiet desperation.
The Porter Page team is made up of state-licensed and certified agents who are either on Medicare themselves, or who have helped family members evaluate their options and come to a decision about their Medicare. As Ruth recalls, “We quickly realized that coaching from the sidelines on a topic as complicated as this just isn’t an option. That’s why we’re in it with our members.”
While benefits under Medicare are divided into multiple parts, each with differing rules and penalties, Ruth and her team slash the monstrous jargon “and simply explain how these things work in real life.” Most Medicare beneficiaries are unaware that when first enrolling in Medicare, they have “once only” choices available to them during their initial enrollment. And, “we help you determine whether you need Medicare Part A and Part B if you are still working.”
As you face confusing health insurance plans, complicated Medicare, or part bull-part man, you can rest easy knowing that Ruth and her team at Porter Page and Company, Inc. have the string and the sword in hand - ready to cut through the red tape and lead you worry free into whatever life you’re dreaming about: apple orchards in New England, or margaritas on the beach.
Question: What choices do people have during Annual Open Enrollment?
Ruth Page: During the Annual Enrollment Period of October 15th to December 7th, individuals entitled to Medicare have the option to switch or enroll in Medicare Advantage Plans, switch prescription drug plans or enroll back into traditional Medicare. Once a change is made, the choice becomes effective January 1st of the next year.
Also, you can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.
Question: What is the one thing most Medicare beneficiaries are unaware of when first going on Medicare?
Ruth Page: Most Medicare beneficiaries don’t realize there is a lot that traditional Medicare does not cover such as vision, dental, hearing, or an annual physical exam. Also, there is no maximum on the out-of-pocket costs. Medicare Part B pays 80% of approved costs and 0% of non-approved or excess charges.
For example, consider someone with only original Medicare having heart by-pass surgery. If their hospital charges $300,000 for the surgery and Medicare only approves $250,000 the patient would pay 20% of $250,000 and the $50,000 excess charge and for a total of $100,000.
Therefore, it’s smart to enroll in either a Medicare Supplement plan or a Medicare Advantage plan. Either option will help you contain your health care costs.
Question: Do I need Medicare Part A or Part B if I am still working?
RP: Even if you have coverage through a current or former employer, you may still need to make some important Medicare enrollment decisions. You may have to pay a penalty if you don’t enroll on time, so it’s best to seek the advice of a Medicare professional to understand how your current coverage works with Medicare before making any decisions.
In most cases, for as long as you have group health insurance provided by an employer, you can delay enrolling in Part B, which covers doctors’ visits and other outpatient services and requires a monthly premium. When you eventually retire, or leave your work plan, you will be entitled to a special enrollment period of eight months to sign up for Part B without incurring a late enrollment penalty. Cobra is not considered creditable coverage regarding the Part B penalty.
It’s a good idea to compare the costs of your employer plan (the monthly premium and the co-pays) with the costs of enrolling in a Medicare Advantage plan. In many cases, you can save money by choosing to enroll in Medicare.
Connect with Ruth Page and the professional team at Porter, Page and Company by calling (949) 297-3917.