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Jim Robeson

Jim Robeson CLU, ChFC

The Medicare Answer Guy

Medicare News

November 2021 Edition

My goal with this newsletter is to:

  • 1

    Keep You Informed I will be sharing current articles about the changes in Medicare.

  • 2

    Answer Your Questions I'm available to answer issues specific to you.

  • 3

    Stay Connected I want to make Medicare coverage as simple as possible.

(858) 935-9120

Birthdays

  • Steve H
  • Merry F
  • Shirley E
  • Buddy D
  • Scott H
  • Kathleen J
  • Jay D
  • Mark B
  • Dale D
  • Richard T
  • Michael C
  • Cliff J
  • Cynthia S
  • Roseanna A
  • Marie J
  • Nicholas T
  • Pete S
  • Joe D
  • Lawrence K
  • Greg C
  • Kim G
  • Kerry P
  • Tom D
  • Charles R
  • James S
  • Patricia R
  • Charles R Sr.

Referrals

  • Dave L referred J Lassiter
  • Linda S referred Miriam W

We try hard to recognize every referral but if we missed anyone, please let us know.

Just send us a quick email so that we can acknowledge you. We want all of you to know that it is our privilege to serve you.

The greatest compliment you pay us is the referral of your family and friends. Thank you!!!

Nitrile Gloved Hands Holding Chalkboard with 'Medicare Annual Enrollment Period' Written

Medicare Enrollment Reminder

Medicare Annual Enrollment Period (AEP) is October 15th - December 7th. If you want to explore your plan options, call or email me before November 25, 2021. I can help you review your current plan options and costs and review benefits as they apply to any upcoming treatment you are planning. I always want to make sure you have the very best Medicare plan available to you.

Beware!

With the Medicare Annual Enrollment Period, AEP, (from October 15 to December 7) in full swing, we are getting a tremendous number of calls about one specific topic. So, let's address the 5,000-pound elephant in the room – the Sharp Direct VIP plan for San Diego Medicare enrollees. For years, there was only ONE Medicare Advantage plan that would get you to Sharp Community, Arch, Graybill and Sharp Rees Stealy doctors… and that was the UnitedHealthcare plans which include Sharp Secure Horizons plan, UHC Plan 4, Sharp Walgreens plan, Assure (Medicare/Medi-Cal) plan or Patriot plan. Sharp and UnitedHealthcare had an exclusive agreement whereby Sharp doctors would only accept the UHC plans.

About 3 years ago, Sharp decided to emulate Kaiser a bit, by offering their own version of an Advantage plan. Many of you, if not all of you, who currently have a UnitedHealthcare plan in San Diego have been receiving letters from Sharp touting the Sharp Direct VIP Advantage plan. That plan and the new UnitedHealthcare Sharp Walgreens plan are very similar in copays for many of the medical services. But they have some important differences as well – the Sharp Direct plan does not have a transportation benefit, their gym membership only allows you to have access to one gym at a time, and the chiropractic and acupuncture benefits have a $10 copay per visit while the UHC plan is $0 copay per visit.

But, the biggest difference if you switch to the Sharp Direct plan, is that you no longer have me as your agent… if fact, you DON'T have an agent at all. So good luck trying to get the person who answers the toll-free number for the Sharp Direct plan to do a 3-way call with you to clear up a billing error, advise you if there is a better plan for you, or help you if you want to change from Sharp doctors to Scripps or UCSD doctors.

Keep this information in mind should you receive information about the Sharp Direct VIP Plan and feel free to contact me to answer questions and review your options.


Young Woman in Dental Exam Chair Getting an X-Ray with Dentist Out of Focus

Dental Insurance

Another question we get almost daily is regarding dental benefits. Some Medicare plans will have basic dental (cleanings, exams, x-rays & fluoride) built in at no additional costs, and some will have a dental rider (either HMO or PPO) that you can add on for a monthly charge. Dental is one of the worst parts of Medicare plan coverage, yet it is the one thing that most seniors need! My philosophy on dental is that you have 3 choices – an HMO plan, a PPO plan or just save your monthly premium in the cookie jar and cover your costs out of pocket. Each option has its pros and cons.

  • HMO Dental insurance – Many dentists won't take it, and those that do are not always that ethical and will often try to "upsell" you services you probably don't need.
  • PPO Dental insurance – More dentists will accept this insurance, but the premiums can be high, there is often a waiting period of 12 months before major services can be done, and almost every PPO plan has a maximum amount of coverage, usually around $1,500.
  • More and more, I am hearing about dentists that don't take ANY insurance. They will often offer payment plans with little or no interest, or a discount off the total price if you pay up front. They are also less likely to try to advise you that you need unnecessary services. If your dentist doesn't take insurance, consider just taking the $50 average monthly premium for an individual PPO Dental plan, and stick it away each month to cover the costs WHEN you do need services.

Personal Note

The holiday season can be a mixed blessing of busy-ness/stress and a time to reflect on our blessings and enjoy family. Diana and I are richly blessed with our extended and blended family (six of whom also have birthdays in the next two months!!). We look forward to spending time with our kids and grandkids, enjoying fellowship and yummy food 😊. We are wishing all of you a lovely Thanksgiving with your friends and family!

Jim Robeson CLU, ChFC

Medicare Made Easy
10755 Scripps Poway Pkwy #617
San Diego, CA 92131| (858) 935-9120
jim@themedicareanswerguy.com
themedicareanswerguy.com

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