CJN goes one-on-one with: Lee Nathans | Health

Lee Nathans has been a registered health underwriter for nearly 30 years and past president of the Columbus and Ohio Health Underwriters Associations.

CJN: What Medicare-related issues are most important to seniors?

Nathan: It’s important that everyone understands how Medicare works, how much Medicare costs, the difference between Original Medicare with the Medicare Supplement along with a prescription drug plan, and a Medicare Advantage plan that may require you to use network providers. Advantage plans often have lower monthly premiums but higher total out-of-pocket costs when using services.

CJN: What are the biggest mistakes new Medicare recipients make?

Nathan: The biggest mistake a Medicare beneficiary can make is not knowing how their individual insurance works and the intricacies of Medicare rules. For example, when someone initially enrolls, their Medicare Supplement coverage is guaranteed without medical coverage for any health problems. However, if someone delays enrolling in the Medicare Supplement program to say they enrolled in an Advantage Plan, they may not be eligible for the supplement because of a change in health. The best way to avoid these problems is to work with a professional Medicare broker who knows your specific individual needs and will match those needs with appropriate Medicare options.

CJN: How can people best prepare for Medicare?

Nathan: Open enrollment in Medicare is a seven-month period that begins three months before the applicant’s 65th birthday and continues three months after the applicant’s birth month. The special enrollment period for Medicare goes into effect when a person age 65 or older who is covered by their current group health insurance plan leaves that plan and switches to Medicare. An individual or couple should contact a professional health insurance broker to review enrollment options as soon as they plan to enroll in Medicare.

CJN: What are the latest trends in Medicare to be aware of?

Nathan: To gain market share, some Medicare Advantage plans offer additional coverage features such as dental, vision, hearing, and other benefits. When considering an Advantage plan to have access to these services, a consumer should fully understand how their plan works and any limitations and out-of-pocket costs they may incur for hospital and medical services.

CJN: What else do people need to know about Medicare?

Nathan: In response to consumer complaints about heavily advertised celebrity-endorsed call centers, Medicare this year is requiring all marketing calls to be recorded and a disclaimer included in all marketing materials. However, the best way to avoid confusion with your Medicare options is to work with a professional Medicare broker.