top of page
Coach Northern

Making sure all your doctors and medicines are covered

As our experienced staff decides how to present Medicare to Missouri and Illinois seniors, we have determined that it is best to cover the most important parts first. We first lead with the mandatory parts. It is not what we think is the simple part, but the necessary part. We have to have your permission to speak to you and discuss your personal pinpoints. And your pinpoints that match a plan, make it commonly simple to be rest assured, you can find a plan to fit your needs snugly.


One madatory point, we have to establish is a Scope of Appointment with you. Literally I refer to this as my "Encyclopedia Salesperson Clause" because it helps to establish the topics we are going to cover during our appointment or online session. Depending on the setting, I have two different approaches to the presentation basics. The short version includes a discrimination disclaimer, HIPAA disclosures on verbal collections of personal data and why, the STAR ratings of plan and a Medicare overview with an agreement of "what we covered" summary. The long version includes the short version, going over in detail all of the above, specific benefits and details matched to your needs.


However, included in both are your current/past, possible doctors and prescriptions. I think these are the most important 2 parts. Possible doctors are usually surgeons or special circumstance doctors you may have to see, but do not see on a regular basis. People love their doctors and some folks cannot live without certain doctors. We have to also cover prescriptions. One thing I have never understood is why all prescription drugs are not covered to some extent by each plan. Nonetheless, in many Medicare health plans, certain prescription drugs are not covered. Unfortunately, many times the drugs of the prospective clients I am presenting to, are not covered. Many of the medically necessary drugs of a prospect, will have the possibility of being covered by a prior authorization filed by the primary care doctor. As you can see, we have to check your medicines and doctors. At the end of your Enrollment, we even do a session recap to make sure we covered all you need.


So I believe that armed with this knowledge, you now realize these are the most important thing to think about. (Doctors & Drugs) And if you were worried previously, do not worry! Armed with this knowledge you can immediately figure out which plans to rule out.


Finally, you can always go to Medicare.gov to check the information presented to you by any agent. It will definitely list all your covered meds for each plan in your area as well as actual covered benefits. See there really are no secrets. But remember words are words and some plans don't actual offer what they have written due to "occasional" "middle of the year changes!" Somehow this happens more often with dental in Medicare Advantage plans. But your doctors and meds listed are almost always covered. Don't forget though, doctors and their staff are human and mistakes can be made. Sometimes the decide to retire, stop accepting certain plans or even bill your account incorrectly. These things can easily be fixed with our help. SO there is no need to panic.


This is why having an agency with agents like ours can be useful. And you do not have pay extra for our service. We can help you file quick appeals with quick responses. And when there are changes or unforeseeable snafu situations, the agent of private plans receive that information before others.


In summary, first check your doctors and meds before you worry about anything else and _KISSSS_ keep it simple, Susie, Sam, Steve!



9 views0 comments

Comments


bottom of page