Today, I’m coming to you because I came across someone who made an innocent Medicare mistake that is now creating chaos for the rest of her family.
I got a call from a friend calling on behalf of her aunt, who had a major stroke and was now extremely weak on half of her body.
Due to her condition, she was unable to care for herself and could not return home following the hospital stay without some rehabilitation services. The family was trying to assess her skilled nursing facility options, and that is why her niece called me.
The family had discovered the facility they wanted her to stay at following the hospital would not accept her Medicare plan.
After researching her current plan, I found out that her aunt had chosen a restrictive HMO Medicare Advantage plan. So now, her family is scrambling around trying to figure out what facility will accept this plan so that her rehabilitation stay will be covered.
The family was spending a ton of time calling and visiting facilities to see if they accepted her health insurance as quickly as they could while trying to juggle full-time jobs and their own personal commitments.
I am sharing this story with you because the aunt assumed that she would be healthy her whole life, so she picked a plan with a low premium not understanding all the restrictions and back-end costs, like the large out-of-pocket maximum she is now facing.
Here’s the thing: we don’t always know what our health future holds, so making an optimistic decision is not realistic.
After helping thousands of people with their Medicare decision, my recommendation is that when you first join Medicare, you should be very thoughtful about the plan and the program that you pick. Don’t just consider your current health status; consider what life would look like if you were to have health issues arise.
The reality is that when most people want to switch plans, it’s too late for them.
Like my friend’s aunt, it’s too late for her. Unfortunately, due to insurability rules, she can’t switch plans. So now she is facing her $8,000 out-of-pocket maximum for the year and will have to rehabilitate in a facility over an hour away from her family because of her plan’s network restrictions.
To get help with your Medicare decision, you can register for my next free online Medicare workshop by going here: https://join.themedicarecoach.com/free-workshop
