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Before Buying Insurance, Examine Plans That Meet Your Needs

Question: Why is that my friend insures with the same health insurance company as I do, but she pays less, so how can I get that cheaper pricing?

Answer: My friend, Amy and I both have Toyotas. We love our vehicles, but mine gets better gas mileage and my monthly payment is lower because I own a Corolla and she owns a Highlander. We have the same company, but different models. Your situation is similar.

There are many different types of Medicare Health Insurance products – Medicare Supplement Plans (Medigaps), prescription drug plans (PDPs), and Medicare Advantage Plans. Those Medicare Advantage Plans come in many different varieties including health maintenance organizations (HMOs), preferred provider organizations (PPOs) and private fee for service plans (PFFS).

There are many health insurance companies that sell products in many of those categories. When talking about health insurance and Medicare products I try to be careful about using a company name like Toyota, and try to use the product name like Corolla.

Here is an example: There are Univera Medicare Advantage Products sold as Univera Senior Choice. Under that name there are six different options. Most providing drug coverage, and one without drug coverage. There are also Univera Medicare Supplement Plans. Under that type of insurance, Univera offers eight different types of Medigaps. Of the 14 possible Univera products listed, the prices range from $0 to $363.7, and the types of products have completely different rules and coverage. Each product is useful for a particular situation. The list of 14 is as different as 14 different fruits and vegetables. One would not say that a grape and pea are the same because they are both round. Similarly, one can’t say that Univera Senior Choice Secure for $140 and Univera Medigap Plan G for $184.70 are the same because both are Univera.

The name of the insurance product type is important in distinguishing the type of coverage you are purchasing.

Mailings from many different companies highlight a particular feature of the plan like $0 premium. Some people ask why they pay $14.20 per month, when they can get a $0 plan which covers dental. The $14.20 per-month-plan is a WellCare Prescription Drug Plan. The $0 premium plan is a WellCare Medicare Advantage product which is either a PPO or PFFS, and may not include prescription drug coverage. All of these products can’t be mixed and matched together. One may end up in a difficult place if one uses just the premium as one’s decision-making threshold.

Advertising is about highlighting features that the company wants the customer to focus on. With insurance products there is definitely more to the story. One can’t compare products strictly using the name or the price point for premium.

Insurance companies sell products because they believe they can create a profit margin to maintain their business model. It is your job to be sure you are getting the best insurance product for your situation. Just because a company offers a product does not mean you need to buy it.

I love to hear about people talking about their insurance coverage and comparing it with other products. I also know that sometimes what people highlight in talking about their insurance is what they love most about it. I love my Toyota Corolla, I get great gas mileage. It has a backup camera and a sun roof- all features that are important to me. It would not be good for Amy. She has four children and a husband. They wouldn’t fit in my Toyota. She needs that Highlander for her family needs.

Be sure to pick out the correct Medicare Insurance product to meet your needs.

Senior Life Matters is a community-based program sponsored by Lutheran Jamestown. For questions and concerns or to reach Janell Sluga call 720-9797 or e-mail SLM@lutheran-jamestown.org.

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