Health Insurance Matters: Why I Do It

By Harry Thal

I am writing this on Sunday morning. The time switched back to Standard time. It is as dark as usual, but the clock tells me it is 4:20 a.m. I actually got to lie in bed an extra hour this morning. Now in the office, I realize that the Medicare Season is three full weeks old.

One of the things I do for our clients and community is to try to help them lower their health insurance costs. Prescription drugs are a major expense for many people, and the cost of health insurance impacts the household budget. I hear people complaining of the cost, but few do anything about it. A year ago, at the close of the Medicare Annual Enrollment Period (AEP) we totaled up the savings that we accumulated by moving people from one Medicare Prescription Plan to another. Our 2018 total was $755,452.70. Better than three-quarters of a million dollars remaining in some people’s pockets.

So far this year, our numbers are equally impressive. We have made recommendations to save $254,974.98 and this total grows each day.

While most of the Prescription Drug Plans (PDP) have increased their cost from the 2018 rates to 2019, several companies are providing lower rates. We have already written in excess of 100 policies with a monthly premium of $15.00 and have been able to place still others at a rate of $12.90 per month. While most insurance agents represent only one or two companies, I represent or can place business with all the plans doing business in California, and have clients in 26 other states.

Another component of what I do is evaluate and recommend better Medicare Advantage (HMO) health plans. Most people tend to stick with the plan they are on, assuming that it worked last year, so it probably will work as well next year. For the most part, this is correct. However, what if there is now a better plan, allowing you to use your same doctor(s) and provide lower prescription costs and provide more benefits, such as possibly free transportation, dental, vision, hearing aids, insulin, generic Viagra, over-the counter medicines, vitamins, Emergency Response Systems, etc.

No plan offers all of these, but with your priorities in mind, it is possible to enhance your benefits and still have a $0 monthly premium here in Kern County.

People on Medi-Cal and Medicare (known as dual eligible or Medi-Medi) a few years back only had one plan to choose from. While this plan may still work, the benefits have not kept up with the new more modern plans. And then there are the diabetics and people with severe chronic heart problems. Several insurance plans get extra federal funding to help these people, and they can get more benefits and care with the properly selected health plan.

A few years ago, there was a health plan called GemCare. They used our primary care doctors here in the valley as well as in Bakersfield but provided many specialists exclusive to just their own clients. Well, GemCare physicians are back, under a new name and available on several of our existing Kern River Valley plans.

So, the question is, why do I do it? The simple answer is I get great pleasure in helping people and using the system to the public’s benefit. As with all health insurance agents, there is never a fee.

The insurance companies pay us directly for the business we write, and the cost remains the same whether you go directly with the company, do it yourself, or use the services of a qualified, certified and licensed health insurance agent that specializes in Medicare.

Harry P. Thal, MA, is a licensed insurance broker in California (0621106) and 26 other states. His offices are in Kernville. He is a member of the Society of Certified Senior Advisors and Past-President of the Kern Association of Health Underwriters. He may be reached at 760-376-2100, e-mail harrythal@aol.com or visit him on the web at www.harrythal.com.

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