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independence hall, philadelphiaOk, so what do you get when you cross an insurance carrier with an ex-politician?

You get an ex-politician who’s taking the money and running and knows absolutely nothing about the Medicare Advantage business. What does this mean to you, the Medicare recipient? Political drivel attempting to steer you to something that just may not work well for your retirement or your health. 

Regarding this latest article on Clover Health:

from the Inquirer Ex Mayor, Michael Nutter, wants to tell you what is best for you when it comes time to choose your Medicare insurance. Let’s take a few minutes and dissect what he’s spewing.

“Now, at the age of 61”

First of all he just stated he’s 61 years old. That means he’s 4 years away from being Medicare eligible, and now he’s attempting to lure you to a carrier who doesn’t even have a stronghold in the area. My customers always tell me that “they have a friend” who’s always trying to give insurance advice. I say to them, never take insurance advice from someone who doesn’t have an insurance license, a license that enables an insurance professional to properly explain how Medicare and Medicare insurance works. Mr Nutter, please produce your insurance license for us. Enlighten us.

“but traditional Medicare has many gaps”

Gaps? Traditional Medicare pays about 80% and if you supplement it with a Medigap plan you can cover the remaining 20%. Did Mayor Nutter explain how Medicare Advantage only covers 80% of Part B specialty drugs?

For example, radiation and chemotherapy drugs? I know some folks who are spending anywhere from $500 to $1100 out of pocket monthly to pay for Part B specialty drugs. Mayor Nutter failed to explain that gap in the article.

What about the inpatient hospital copay? The outpatient hospital copay? The referral system? The emergency room copay? The skilled nursing care copay? The x-ray and MRI copy? Do I really need to go on? These are just a few of the gaps Mayor Nutter did not talk about because he doesn’t even know about the plan he’s recommending. He doesn’t know enough to be able to compare Traditional Medicare to Medicare Advantage. He’s a paid endorser by the said Medicare Advantage Carrier.

“The problem is that not enough of our seniors sign up for Medicare Advantage. More than 250,000 people in Philadelphia qualify for Medicare, but only 112,000 – less than half of the eligible population – are on a Medicare Advantage plan. That means nearly 10 percent of Philadelphians aren’t getting the most comprehensive health coverage that is readily available to them.”

Wow! Mayor Nutter has decided that he knows what’s best for you and wants to lure everyone, including Medigap policy holders that Medicare Advantage is the way to go. One Insurance carrier for all! In all my years assisting seniors with their Medicare insurance I never once had a client who wanted to trade in their Medigap policy for an Advantage plan.

Why? Because when it was their turn to choose a plan at their time of retirement they reviewed all their options. They didn’t have an ex-politician stuffing his pockets baiting them. They chose the plan that suited their needs and retirement monies.

Just as the Medicare Advantage policyholder did at their election time, they reviewed all their options. Did Mayor Nutter explain that once you choose a Medicare Advantage plan that you never be able to join traditional Medicare with a Medigap plan? Of course he didn’t, because he doesn’t know the rules because he’s not insurance licensed and he’s being payed to lure seniors into a Medicare Advantage that is brand new to the area.

Just imagine if you do take his word for it and decide to sign up. What if you suddenly need to see a doctor, a specialist or worse you need to be hospitalized and then you find out your insurance is not accepted. Why? Because carriers new to any area have very limited networks.

As a broker I’ve seen this story a hundred times a year. Guess what, if you’re not in the Annual Enrollment Period you are stuck with the insurance carrier that Mr Nutter peddled you into for the remaining year, doctor bills and all! Mayor Nutter failed to explain that in Traditional Medicare you have an open network throughout the United States and you will never need a referral. He didn’t explain it because he’s being paid to tout a plan that does not have an open network.

“Part of my work in this next phase of my life will be dedicated to spreading the word about the benefits of Medicare Advantage in Philadelphia.”

Ok, what happens when he decides not to be a paid spokesman any longer, or Clover drops him? Will it still be part of his life’s work? Will he still care about your retirement or your personal healthcare? Is he going to make a house-call and change your insurance for the better? I think you already know the answer to this.

“What makes Clover Health unique, and why I chose to work with them, is how they combine technology with compassion, quality medical care, and a focus on prevention. They go beyond normal Medicare Advantage, using a high-tech approach to deliver proactive results to their members – keeping them healthy and enjoying their lives. They serve seniors by sending nurse practitioners for in-home visits when they feel a person is at risk of high blood pressure, hasn’t taken their medicine, or is having trouble managing their sugar and diabetes.”

Really, you don’t say Mayor. As a broker for many top Medicare Advantage companies such as Independence Blue Cross, Aetna, United Healthcare just to name a few; by the way all these carriers have an extensive network in our Philadelphia area and actually do have a stronghold, and have extensive preventative benefits.

They even include “Silver Sneakers” which will pay your membership to a gym, so you can get the exercise you need. Not to mention dental, vision, hearing, 24/7 access to doctors, wellness programs, traveling, and over the counter benefits.

“So, Philadelphia, you may start hearing my voice on the radio or seeing me on TV talking about my new cause. And if you or your parents sign up for our Medicare Advantage plan, then I’ll know the message is getting through.”

I fail to see how this is Nutter’s “new cause” when the insurance carrier is lining his pockets as a paid spokesman. A cause is something you take up because of a belief, not because you’re getting paid. Look, I like Robert Deniro as an actor, but I’m not buying something just because he’s in a commercial selling a particular car, bed, television or his latest watch. I’m buying it because it’s right for me.

The Annual Enrollment Period is upon us, so let me tell every Medicare recipient to do your due diligence. That means sit down with a licensed broker who lives in the Philadelphia area and who’s appointed with all the major insurance carriers in your area, so you can make the smart choice. You want to work with a broker who’s willing to share his phone number, email address and contact information.

Joe Bachmeier – BGA Insurance Group Co-Founder

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You want the licensed broker who’s willing to be accountable and patient to your needs. By the way, did Mayor Nutter include his cell or email address in that article? Whether it’s Medicare Advantage or traditional Medicare, I always tell people there is a need for either one, but it depends what your goals are and what you can afford. Don’t let a paid spokesman make that decision for you, he’s paid to push you in one direction whether its right or wrong for you.

If your mind is set on choosing the Advantage route, then do your due diligence because there are a couple of $0 premium plans that are available in 2019 through Aetna and Blue Cross, two of the best carriers at Medicare Advantage plans and who have the largest network of doctors and specialists.

When you get a moment ask us about the Aetna Silver PPO plan at $0 premium, yes, a brand-new PPO plan that you pay $0 per month. That means you get a PPO plan and you never need a referral for specialists.  Also, don’t forget the Independence Blue Cross Basic Rx HMO plan at $0 per month and its large network.

BGA Insurance specializes in both Medicare Advantage, Medigap plans, and Part D prescription plans.