Betty – Ariz.: I have a complicated medical history. I am now disabled and on Medicare. I have a Medicare Advantage plan, but it only pays 70 percent of my covered expenses and leaves me with a significant bill for many procedures. I tried to get Original Medicare with a Medigap policy, but I could not get approved for either plan G or F due to pre-existing conditions. I very much need to have a plan that picks up more of the gap that’s left in my medical bills. Living on disability leaves me with a very restricted income. I simply cannot meet financial obligations with my current income. Do you have any insight on how I might best correct this gap in my medical bills?
Phil Moeller: Betty, I’m so sorry you’re having a hard time. I am surprised when you say your health plan pays only 70 percent of covered services. Medicare Advantage plans are legally required to offer benefits at least as good as those available from Original Medicare, and it pays 80 percent of covered services. I think you should call a Medicare SHIP counselor in Arkansas at 1-800-224-6330 and review your current coverage. You also should check with the counselor about whether your income is low enough to qualify you for one of several Medicare Savings Programs that can help you with premiums and other insurance expenses. Additionally, there is an Extra Help program that helps pay for prescription drugs under Medicare’s Part D drug program (which I’m assuming is bundled into your Medicare Advantage plan). The counselor will help you compare other Medicare insurance options where you live. And if it turns out that changing insurance makes sense, you can do so during Medicare’s annual open enrollment period, which begins on Oct. 15 and extends through Dec. 7.